Contract Pharmacy Details

CAREMARK, L.L.C.
DSH330214 NYU Langone Hospitals

Covered Entity Details

Entity Name

NYU Langone Hospitals

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH330214

Entity Address

550 FIRST AVENUE
NEW YORK, NY 10016

Medicare Provider Number

330214

Participating Start Date

1/1/2016

Last Recertification Date

8/14/2024

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

7/18/2016

Contract Begin Date

10/1/2016

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Michael Burke, Corporate Chief Financial Officer
(212) 263-3092

Contract Pharmacy Representative

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

Signed By Date

7/18/2016

340B Drug Pricing Program Database