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PROCARE PHARMACY, L.L.C.
STD19134 Prevention Point Philadelphia
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Covered Entity Details
Entity Name
Prevention Point Philadelphia
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD19134
Entity Address
2913-2915 Kensington Ave
Philadelphia, PA 19134
Grant Number
NH25PS0051450100
Participating Start Date
10/1/2019
Last Recertification Date
5/8/2024
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
7/1/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Anne Kelly, Medical Services Sustainability Manager
(215) 589-5555
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/1/2020
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