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PROCARE PHARMACY, L.L.C.
DSH340113 CAROLINAS MEDICAL CENTER
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Covered Entity Details
Entity Name
CAROLINAS MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340113
Entity Address
1000 BLYTHE BLVD
CHARLOTTE, NC 28203
Medicare Provider Number
340113
Participating Start Date
8/1/1993
Last Recertification Date
9/4/2024
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
10/19/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Don McCoy Mabe, VP, Pharmacy
(704) 512-7623
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/19/2020
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