Contract Pharmacy Details

CAREMARK, L.L.C.
DSH210012 SINAI HOSPITAL OF BALTIMORE

Covered Entity Details

Entity Name

SINAI HOSPITAL OF BALTIMORE

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH210012

Entity Address

2401 WEST BELVEDERE AVENUE
BALTIMORE, MD 21215

Medicare Provider Number

210012

Participating Start Date

7/1/2003

Last Recertification Date

8/15/2024

Pharmacy Details

Pharmacy Name

CAREMARK, L.L.C.

Pharmacy Address

DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
1127 BRYN MAWR AVE
SUITE A
REDLANDS, CA 92374

Pharmacy Comments

Contract Details

Approval Date

7/15/2016

Contract Begin Date

10/1/2016

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

NEIL MELTZER, PRESIDENT/CEO
(410) 601-5134

Contract Pharmacy Representative

CVS/Caremark
Jason Kwasigroch, Sr. Advisor, Specialty CVS/caremark
(847) 559-5619

Signed By Date

7/15/2016

340B Drug Pricing Program Database