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PROCARE PHARMACY, L.L.C.
CHC02456-00 WINDROSE HEALTH NETWORK, INC.
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Covered Entity Details
Entity Name
WINDROSE HEALTH NETWORK, INC.
Subdivision Name
Windrose Health Network - Trafalgar
Type
HRSA-Funded Health Center
340B ID
CHC02456-00
Entity Address
14 Trafalgar Sq
Trafalgar, IN 46181-9515
Grant Number
H80CS02456
Participating Start Date
10/1/2016
Last Recertification Date
2/11/2025
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
1/13/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Scott K Rollett, CEO
(317) 739-4895 Ext: 2401
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/13/2021
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