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PROCARE PHARMACY, L.L.C.
DSH340141 Novant Health New Hanover Regional Medical Center
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Covered Entity Details
Entity Name
Novant Health New Hanover Regional Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340141
Entity Address
2131 South 17th Street
Attn: Pharmacy
Wilmington, NC 28401
Medicare Provider Number
340141
Participating Start Date
10/1/2003
Last Recertification Date
8/26/2024
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
7/29/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Laurie Whalin, VP of Clinical Support Services
(910) 667-7731
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/14/2020
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