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CAREMARK ILLINOIS SPECIALTY PHARMACY, LL
DSH310016 CHRIST HOSPITAL
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Covered Entity Details
Entity Name
CHRIST HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH310016
Entity Address
176 PALISADES AVENUE
JERSEY CITY, NJ 07306
Medicare Provider Number
310016
Participating Start Date
1/1/2025
Last Recertification Date
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
Angela Murdock-Ridley, VP of Finance, CFO
(718) 930-5259
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/15/2025
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