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PROCARE PHARMACY, L.L.C.
RWII19403 Family Service of Montgomery County, Pennsylvania
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Covered Entity Details
Entity Name
Family Service of Montgomery County, Pennsylvania
Subdivision Name
Type
Ryan White Part B
340B ID
RWII19403
Entity Address
3125 Ridge Pike
Eagleville, PA 19403
Grant Number
X07HA00021
Participating Start Date
4/1/2015
Last Recertification Date
2/12/2020
Entity Termination Date
4/1/2021
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
4/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Tim O'Connell, Dir. Special Projects
(610) 630-2111 Ext: 224
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/14/2020
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