340B Drug Pricing Program Database
PROCARE PHARMACY, L.L.C.
RRC180104-00 BAPTIST HEALTH PADUCAH - information as of 6/2/2025 9:03:19 AM
Covered Entity Details
Entity Name
BAPTIST HEALTH PADUCAH
Subdivision Name
Type
Rural Referral Center
340B ID
RRC180104-00
Entity Address
2501 KENTUCKY AVENUE
PADUCAH, KY 42003
Medicare Provider Number
180104
Participating Start Date
1/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY OR CARELONRX SPECIALTY
ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1
HONOLULU, HI 96813
Pharmacy Comments
3/22/10 NAME CORRECTION (WAS CVS PROCARE PHARMACY DBA CVS PROCARE PHARMACY #2915) 3/17/10 ADDR CHANGE (WAS 970 N KALAHEO AVE, SUITE A 203)
Contract Details
Approval Date
4/1/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kenneth Boyd, President
(270) 575-2101
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/1/2025
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session