Contract Pharmacy Details

CAREMARK NORTH CAROLINA SPECIALTY PHARMA
DSH330057 ST. PETERS HOSPITAL

Covered Entity Details

Entity Name

ST. PETERS HOSPITAL

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH330057

Entity Address

315 S. MANNING BLVD.
ALBANY, NY 12208

Medicare Provider Number

330057

Participating Start Date

4/1/2024

Last Recertification Date

8/19/2024

Pharmacy Details

Pharmacy Name

CAREMARK NORTH CAROLINA SPECIALTY PHARMA

Pharmacy Address

DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
10700 WORLD TRADE BLVD STE 110
RALEIGH, NC 27617

Pharmacy Comments

Contract Details

Approval Date

4/9/2025

Contract Begin Date

7/1/2025

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Lori Santos, CFO
(518) 525-5537

Contract Pharmacy Representative

CVS
Christian Reed, Sr. Director
(401) 770-2118

Signed By Date

4/9/2025

340B Drug Pricing Program Database