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PROCARE PHARMACY DIRECT, L.L.C.
FQHCLA407C Metropolitan Charities, Inc.
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Covered Entity Details
Entity Name
Metropolitan Charities, Inc.
Subdivision Name
METRO St. Petersburg
Type
Health Center Program Look-Alike
340B ID
FQHCLA407C
Entity Address
3251 3rd Ave N
Saint Petersburg, FL 33713-8506
Grant Number
LALCS35348
Participating Start Date
4/14/2020
Last Recertification Date
2/9/2023
Entity Termination Date
4/1/2024
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY DIRECT, L.L.C.
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
105 MALL BOULEVARD
MONROEVILLE, PA 15146
Pharmacy Comments
12/11/2009 - PHARMACY MOVED FROM 600 PENN CENTER BLVD., PITTSBURGH, PA 15235-5810 AND NAME CHANGE (WAS PROCARE PHARMACY DIRECT, INC DBA PHARMACARE SPECIALTY PHARMACY)
Contract Details
Approval Date
4/15/2020
Contract Begin Date
4/21/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Priya Rajkumar, Chief Executive Officer
(727) 321-3854 Ext: 1230
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/15/2020
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