Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
RWII13204 AIDS Community Resources, Inc.

Covered Entity Details

Entity Name

AIDS Community Resources, Inc.

Subdivision Name

Type

Ryan White Part B

340B ID

RWII13204

Entity Address

627 West Genesee Street
Syracuse, NY 13204

Grant Number

X07HA00025-34-01

Participating Start Date

1/1/2014

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

10/15/2018

Contract Begin Date

1/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/31/2023
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Wil Murtaugh, Executive Director
(315) 475-2430 Ext: 2400

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

10/15/2018

340B Drug Pricing Program Database