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PROCARE PHARMACY, L.L.C.
STD283011 Community Health Interventions and Sickle Cell Agency, Inc
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Covered Entity Details
Entity Name
Community Health Interventions and Sickle Cell Agency, Inc
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD283011
Entity Address
2409 Murchison Road
Fayetteville, NC 28301
Grant Number
6 NH25PS005152-05-07
Participating Start Date
10/1/2019
Last Recertification Date
5/22/2024
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #2923
3250 HARDEN ST. EXT. SUITE #300
COLUMBIA, SC 29203
Pharmacy Comments
Contract Details
Approval Date
10/15/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Delvin McAllister, CEO
(910) 488-6118
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2019
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