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ADVANCED CARE SCRIPTS, INC
DSH490052 RIVERSIDE REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
RIVERSIDE REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH490052
Entity Address
500 J Clyde Morris Blvd
NEWPORT NEWS, VA 23601
Medicare Provider Number
490052
Participating Start Date
7/1/2008
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
ADVANCED CARE SCRIPTS, INC
Pharmacy Address
CVS/SPECIALTY OR CARELONRX SPECIALTY PHA
6251 CHANCELLOR DRIVE
SUITE 101
ORLANDO, FL 32809
Pharmacy Comments
Contract Details
Approval Date
4/5/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
WILLIAM W. AUSTIN JR., SENIOR VP & CFO
(757) 534-7015
Contract Pharmacy Representative
CVS/Caremark
Jason Kwasigroch, Sr. Advisor, Specialty CVS/caremark
(847) 559-5619
Signed By Date
4/5/2018
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