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PROCARE PHARMACY, L.L.C.
RWII36609 AIDS Alabama South, LLC
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Covered Entity Details
Entity Name
AIDS Alabama South, LLC
Subdivision Name
Type
Ryan White Part B
340B ID
RWII36609
Entity Address
4321 Downtowner Loop North
Mobile, AL 36609
Grant Number
X07HA00049
Participating Start Date
10/1/2017
Last Recertification Date
2/13/2025
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
10/15/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Shey Lesley Thorn, Co-Executive Director
(205) 918-8224
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2020
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