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PROCARE PHARMACY, L.L.C.
STD89106 Carewell, Inc. d.b.a. Advancing Health Access of Nevada C2100079
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Covered Entity Details
Entity Name
Carewell, Inc. d.b.a. Advancing Health Access of Nevada C2100079
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD89106
Entity Address
501 South Rancho Drive
I-61
Las Vegas, NV 89106
Grant Number
NH25PS005179-04-00
Participating Start Date
2/1/2021
Last Recertification Date
5/19/2022
Entity Termination Date
4/1/2023
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
2/1/2021
Contract Begin Date
2/22/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Ronald Kooch, COO
(951) 345-3053
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/15/2021
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