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PROCARE PHARMACY, L.L.C.
CH0910250 MENDOCINO COAST CLINICS, INC.
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Covered Entity Details
Entity Name
MENDOCINO COAST CLINICS, INC.
Subdivision Name
MENDOCINO COAST CLINICS, INC.
Type
HRSA-Funded Health Center
340B ID
CH0910250
Entity Address
205 South St
Fort Bragg, CA 95437-5540
Grant Number
H80CS00876
Participating Start Date
1/1/2001
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY OR CARELONRX SPECIALTY
ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1
HONOLULU, HI 96813
Pharmacy Comments
3/22/10 NAME CORRECTION (WAS CVS PROCARE PHARMACY DBA CVS PROCARE PHARMACY #2915) 3/17/10 ADDR CHANGE (WAS 970 N KALAHEO AVE, SUITE A 203)
Contract Details
Approval Date
10/6/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lucresha Renteria, Executive Director
(707) 964-1251 Ext: 3433
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/6/2020
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