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PROCARE PHARMACY, L.L.C.
STD752151 Abounding Prosperity, Inc.
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Covered Entity Details
Entity Name
Abounding Prosperity, Inc.
Subdivision Name
HOPE Health Center
Type
Sexually Transmitted Diseases
340B ID
STD752151
Entity Address
Abounding Prosperity, Inc HOPE Health Center
1619 Martin Luther King Jr. Blvd
Dallas, TX 75215
Grant Number
NU62PS924529
Participating Start Date
10/1/2017
Last Recertification Date
5/7/2024
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
7/12/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John Moyle, Nurse Practitioner (only monitor 340b database on behalf of CEO Tamara Stephney))
(469) 213-9593
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/12/2020
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