340B Drug Pricing Program Database
PROCARE PHARMACY, L.L.C.
STD06897 Sagebrush Health Services - information as of 4/28/2025 11:46:18 PM
Covered Entity Details
Entity Name
Sagebrush Health Services
Subdivision Name
Wilton Clinic - Vivo
Type
Sexually Transmitted Diseases
340B ID
STD06897
Entity Address
249 Danbury Rd
201
Wilton, CT 06897
Grant Number
6 NU62PS924521-04-02
Participating Start Date
5/9/2023
Last Recertification Date
Entity Termination Date
1/1/2024
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY #2909
1521 4TH AVE., SOUTH
BIRMINGHAM, AL 35233
Pharmacy Comments
Contract Details
Approval Date
7/26/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Jami Dybik, Vice President
(843) 814-5177
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/26/2023
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