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PROCARE PHARMACY, L.L.C.
CH021790 HUDSON HEADWATERS HEALTH NETWORK
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Covered Entity Details
Entity Name
HUDSON HEADWATERS HEALTH NETWORK
Subdivision Name
Hudson Headwaters Administrative Offices
Type
HRSA-Funded Health Center
340B ID
CH021790
Entity Address
9 CAREY ROAD
QUEENSBURY, NY 12804
Grant Number
H80CS00159
Participating Start Date
4/1/2001
Last Recertification Date
2/10/2025
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
7/10/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/19/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Christopher Tournier, CFO
(518) 761-0300 Ext: 31558
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/10/2020
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