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PROCARE PHARMACY, L.L.C.
STD33174 Latinos Salud, Inc.
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Covered Entity Details
Entity Name
Latinos Salud, Inc.
Subdivision Name
Miami Southwest
Type
Sexually Transmitted Diseases
340B ID
STD33174
Entity Address
8946 SW 40th St
Miami, FL 33165
Grant Number
5 NU62PS924749-02-00
Participating Start Date
10/1/2020
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
8/5/2020
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
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