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PROCARE PHARMACY, L.L.C.
RWI10003 AIDS Service Center of Lower Manhattan Inc
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Covered Entity Details
Entity Name
AIDS Service Center of Lower Manhattan Inc
Subdivision Name
Type
Ryan White Part A
340B ID
RWI10003
Entity Address
64 W35th Street - 3rd Fl.
New York, NY 10001
Grant Number
H89HA00015
Participating Start Date
6/11/2013
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 2919
126 EIGHTH AVE.
NEW YORK, NY 10011
Pharmacy Comments
Contract Details
Approval Date
7/17/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/25/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Sharen I. Duke, ED/CEO
(212) 645-0875 Ext: 304
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/17/2018
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