Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
STD462012 DAMIEN CENTER INC, THE

Covered Entity Details

Entity Name

DAMIEN CENTER INC, THE

Subdivision Name

Type

Sexually Transmitted Diseases

340B ID

STD462012

Entity Address

26 N Arsenal Avenue
Indianapolis, IN 46201

Grant Number

NU62PS924804

Participating Start Date

10/1/2019

Last Recertification Date

5/21/2024

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

7/14/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

5/11/2022
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Alan Witchey, President and CEO
(317) 632-0123 Ext: 266

Contract Pharmacy Representative

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

Signed By Date

7/14/2020

340B Drug Pricing Program Database