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PROCARE PHARMACY, L.L.C.
STD029071 Rhode Island Public Health Institute
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Covered Entity Details
Entity Name
Rhode Island Public Health Institute
Subdivision Name
DBA Open Door Health
Type
Sexually Transmitted Diseases
340B ID
STD029071
Entity Address
7-9 Central Street
Providence, RI 02907
Grant Number
NH25PS005160
Participating Start Date
1/1/2020
Last Recertification Date
5/7/2024
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
10/9/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Amy Stewart Nunn, Executive Director
(401) 307-3948
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/9/2020
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