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PROCARE PHARMACY, L.L.C.
CH021887T SUNSET PARK HEALTH COUNCIL, INC.
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Covered Entity Details
Entity Name
SUNSET PARK HEALTH COUNCIL, INC.
Subdivision Name
Callen-Lorde 17th Street
Type
HRSA-Funded Health Center
340B ID
CH021887T
Entity Address
230 W 17TH ST
NEW YORK, NY 10011-5325
Grant Number
H80CS07914
Participating Start Date
7/1/2015
Last Recertification Date
3/6/2025
Entity Termination Date
7/1/2025
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
1/8/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/30/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Larry K. McReynolds, Executive Director
(718) 630-7216
Contract Pharmacy Representative
CVS Health
Lynn Tardie, Pharmacy Enrollment Coordinator
(401) 770-2761
Signed By Date
1/8/2021
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