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CAREMARK MICHIGAN SPECIALTY PHARMACY, LL
DSH330214 NYU Langone Hospitals
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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 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
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
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