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PROCARE PHARMACY, L.L.C.
STD322082 Jacksonville Health and Educational Resource Center, INC
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Covered Entity Details
Entity Name
Jacksonville Health and Educational Resource Center, INC
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD322082
Entity Address
1024 Edgewood Ave W.
Jacksonville, FL 32208
Grant Number
NH25PS005131
Participating Start Date
7/1/2020
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
7/12/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lolita D. Hill, CEO
(904) 535-1658
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/12/2020
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