Contract Pharmacy Details

CAREMARK, L.L.C.
DSH220095 HENRY HEYWOOD MEMORIAL HOSPITAL

Covered Entity Details

Entity Name

HENRY HEYWOOD MEMORIAL HOSPITAL

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH220095

Entity Address

242 GREEN STREET
GARDNER, MA 01440

Medicare Provider Number

220095

Participating Start Date

4/1/2025

Last Recertification Date

Pharmacy Details

Pharmacy Name

CAREMARK, L.L.C.

Pharmacy Address

DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
7251 S. EASTERN AVE.
LAS VEGAS, NV 89119

Pharmacy Comments

Contract Details

Approval Date

4/14/2025

Contract Begin Date

7/1/2025

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

John Bujak, Chief Financial Officer
(978) 630-6202

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

4/14/2025

340B Drug Pricing Program Database