Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
STD331402 Latinos Salud, Inc.

Covered Entity Details

Entity Name

Latinos Salud, Inc.

Subdivision Name

Medical Mobile Unit Miami-Dade

Type

Sexually Transmitted Diseases

340B ID

STD331402

Entity Address

925 Arthur Godfrey Road
Suite 200
Miami Beach, FL 33140

Grant Number

2 NU62PS924749-02-00

Participating Start Date

4/17/2020

Last Recertification Date

5/6/2024

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

7/8/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Stephen Fallon, PhD, Executive Director
(786) 310-3152

Contract Pharmacy Representative

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

Signed By Date

7/8/2020

340B Drug Pricing Program Database