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PROCARE PHARMACY, L.L.C.
CH010480 NORTHWEST COMMUNITY HEALTH CARE
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Covered Entity Details
Entity Name
NORTHWEST COMMUNITY HEALTH CARE
Subdivision Name
DBA WellOne Primary Medical and Dental Care
Type
HRSA-Funded Health Center
340B ID
CH010480
Entity Address
36 BRIDGE WAY
PASCOAG, RI 02859
Grant Number
H80CS00308
Participating Start Date
10/1/2003
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #2293
2 DUDLEY STREET SUITE 170
PROVIDENCE, RI 02905
Pharmacy Comments
Contract Details
Approval Date
4/1/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Peter Bancroft, President & CEO
(401) 285-5119
Contract Pharmacy Representative
CVS
Kathryn Ficca, Account Manager
(401) 772-7339
Signed By Date
4/1/2020
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