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CAREMARK KANSAS SPECIALTY PHARMACY
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 KANSAS SPECIALTY PHARMACY
Pharmacy Address
CVS/SPECIALTY OR CARELONRX SPECIALTY PHA
11162 RENNER BLVD
LENEXA, KS 66219
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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