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CAREMARK MICHIGAN SPECIALTY PHARMACY, LL
DSH510022 CHARLESTON AREA MEDICAL CENTER (CAMC)
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Covered Entity Details
Entity Name
CHARLESTON AREA MEDICAL CENTER (CAMC)
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH510022
Entity Address
501 MORRIS STREET
CHARLESTON, WV 25301
Medicare Provider Number
510022
Participating Start Date
9/22/2005
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
CAREMARK MICHIGAN SPECIALTY PHARMACY, LL
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
1307 ALLEN DR STE H
TROY, MI 48083
Pharmacy Comments
Contract Details
Approval Date
4/13/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
STEPHEN BELL, VICE PRESIDENT - FINANCE
(304) 388-6251
Contract Pharmacy Representative
CVS
Tom Aitas, Senior Director, Specialty Product Development
(248) 968-6000
Signed By Date
4/13/2017
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