Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
RWI30303 Aniz, Inc.

Covered Entity Details

Entity Name

Aniz, Inc.

Subdivision Name

Type

Ryan White Part A

340B ID

RWI30303

Entity Address

236 Forsyth Street SW Suite 300
Atlanta, GA 30303

Grant Number

H89HA00007

Participating Start Date

10/1/2017

Last Recertification Date

2/18/2025

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

3/20/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Zina Age, President CEO
(404) 502-9982

Contract Pharmacy Representative

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

Signed By Date

7/1/2020

340B Drug Pricing Program Database