Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
DSH440039 Vanderbilt University Medical Center d/b/a Vanderbilt University Hospital and Clinic

Covered Entity Details

Entity Name

Vanderbilt University Medical Center d/b/a Vanderbilt University Hospital and Clinic

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH440039

Entity Address

1211 MEDICAL CENTER DRIVE
NASHVILLE, TN 37232

Medicare Provider Number

440039

Participating Start Date

7/1/2002

Last Recertification Date

8/20/2024

Pharmacy Details

Pharmacy Name

PROCARE PHARMACY, L.L.C.

Pharmacy Address

DBA CVS/PHARMACY #11188
979 EAST THIRD STREET, STE 120
CHATTANOOGA, TN 37403

Pharmacy Comments

Contract Details

Approval Date

10/8/2020

Contract Begin Date

1/1/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

2/28/2025
Pharmacy closed

Contacts

Covered Entity Signing Official

Cecelia Britt Moore, Chief Financial Officer
(615) 322-0084

Contract Pharmacy Representative

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

Signed By Date

10/8/2020

340B Drug Pricing Program Database