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PROCARE PHARMACY, L.L.C.
STD76011 Health Education Learning Project
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Covered Entity Details
Entity Name
Health Education Learning Project
Subdivision Name
Arlington Clinic
Type
Sexually Transmitted Diseases
340B ID
STD76011
Entity Address
602 E. South Street
Arlington, TX 76010
Grant Number
NH25PS005182
Participating Start Date
4/1/2018
Last Recertification Date
5/6/2025
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #2751
426 S. HENDERSON STREET
FORT WORTH, TX 76104
Pharmacy Comments
Contract Details
Approval Date
10/10/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
DeeJay Johannessen, Chief Executive Officer
(817) 332-7722
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/10/2018
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