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CAREMARK FLORIDA SPECIALTY PHARMACY LLC
DSH100093 BAPTIST HOSPITAL
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Covered Entity Details
Entity Name
BAPTIST HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH100093
Entity Address
123 Baptist Way
PENSACOLA, FL 32503
Medicare Provider Number
100093
Participating Start Date
4/1/2009
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
CAREMARK FLORIDA SPECIALTY PHARMACY LLC
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
7930 WOODLAND CENTER BLVD STE 500
TAMPA, FL 33614
Pharmacy Comments
Contract Details
Approval Date
7/17/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Andrew L. Terry, Vice President Revenue Management
(850) 469-7643
Contract Pharmacy Representative
CVS
Terita Peterson, Senior Director, Specialty Product Development
(813) 882-5550
Signed By Date
7/17/2017
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