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CAREMARK NEW JERSEY SPECIALTY PHCY, LLC
CHC26626-00 FOUNDCARE INC.
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Covered Entity Details
Entity Name
FOUNDCARE INC.
Subdivision Name
FoundCare Health Center
Type
HRSA-Funded Health Center
340B ID
CHC26626-00
Entity Address
2330 S. Congress Avenue
West Palm Beach, FL 33406-7608
Grant Number
H80CS26626
Participating Start Date
4/1/2014
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
CAREMARK NEW JERSEY SPECIALTY PHCY, LLC
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
180 PASSAIC AVE UNIT B-5
FAIRFIELD, NJ 07004
Pharmacy Comments
Contract Details
Approval Date
4/11/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/30/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Rik Pavlescak, Chief Administrative Officer
(561) 432-7902
Contract Pharmacy Representative
Advanced Care Scripts
Jason Kwasigroch, Pharmacist in Charge
(877) 985-6337
Signed By Date
4/11/2017
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