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PROCARE PHARMACY, L.L.C.
STD18017 Novus Adult Care Services
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Covered Entity Details
Entity Name
Novus Adult Care Services
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD18017
Entity Address
1565 Linden Street
Bethlehem, PA 18017
Grant Number
NH25PS005144
Participating Start Date
4/1/2016
Last Recertification Date
5/6/2024
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY # 02553
1117 WALNUT ST.
PHILADELPHIA, PA 19107
Pharmacy Comments
Contract Details
Approval Date
7/13/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Allen Smith, Program Director
(610) 867-5365
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/13/2018
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