Contract Pharmacy Details

CAREMARK TENNESSEE SPECIALTY PHARMACY, L
FQHCLA334 NEW YORK CITY HEALTH AND HOSPITALS CORPORATION

Covered Entity Details

Entity Name

NEW YORK CITY HEALTH AND HOSPITALS CORPORATION

Subdivision Name

Washington Heights

Type

Health Center Program Look-Alike

340B ID

FQHCLA334

Entity Address

600 W 168th St
New York, NY 10032-3702

Grant Number

LALCS00169

Participating Start Date

7/1/2015

Last Recertification Date

1/31/2017

Entity Termination Date

4/1/2018

Pharmacy Details

Pharmacy Name

CAREMARK TENNESSEE SPECIALTY PHARMACY, L

Pharmacy Address

DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
8370 WOLF LAKE DR
STE 107
BARTLETT, TN 38133

Pharmacy Comments

Contract Details

Approval Date

7/11/2017

Contract Begin Date

10/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/27/2017
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Paul Albertson, Vice President
(212) 748-2256

Contract Pharmacy Representative

CVS HEALTH
Joan O'Rourke, VP Specialty Program Management
(847) 559-5282

Signed By Date

7/11/2017

340B Drug Pricing Program Database