Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
CHC31892-02 Centerplace Health, Inc.

Covered Entity Details

Entity Name

Centerplace Health, Inc.

Subdivision Name

North Port Health Center

Type

HRSA-Funded Health Center

340B ID

CHC31892-02

Entity Address

North Port Health Center
6950 Outreach Way
North Port, FL 34287-3405

Grant Number

H80CS31892

Participating Start Date

10/1/2018

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

7/14/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Melissa Jo Parker, Chief Executive Officer
(941) 529-0244

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