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CAREMARK ILLINOIS SPECIALTY PHARMACY, LL
FQHCLA328H COUNTY OF SAN JOAQUIN
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Covered Entity Details
Entity Name
COUNTY OF SAN JOAQUIN
Subdivision Name
Mobile Clinic #1
Type
Health Center Program Look-Alike
340B ID
FQHCLA328H
Entity Address
500 W Hospital Rd
French Camp, CA 95231-9693
Grant Number
LALCS00158
Participating Start Date
7/1/2023
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
CAREMARK ILLINOIS SPECIALTY PHARMACY, LL
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
800 BIERMANN CT STE B
MOUNT PROSPECT, IL 60056
Pharmacy Comments
Contract Details
Approval Date
4/15/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rachna Sharma, Controller
(209) 953-3738
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/15/2025
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