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PROCARE PHARMACY, L.L.C.
SCH240044-00 WINONA HEALTH SERVICES
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Covered Entity Details
Entity Name
WINONA HEALTH SERVICES
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH240044-00
Entity Address
855 MANKATO AVE
WINONA, MN 55987-0600
Medicare Provider Number
240044
Participating Start Date
4/1/2019
Last Recertification Date
8/21/2024
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
1/15/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Robin Jean Hoeg, Chief Operating Officer of Hospital and Primary Care Services
(507) 453-3789
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/15/2021
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