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PROCARE PHARMACY, L.L.C.
CH0310560 JOHNSON HEALTH CENTER
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Covered Entity Details
Entity Name
JOHNSON HEALTH CENTER
Subdivision Name
JOHNSON HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH0310560
Entity Address
320 Federal St
Lynchburg, VA 24504-2306
Grant Number
H80CS02445
Participating Start Date
10/1/2004
Last Recertification Date
2/10/2025
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
11/13/2020
Contract Begin Date
11/13/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Gary Campbell, CEO
(434) 455-2480 Ext: 1102
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
11/13/2020
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