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PROCARE PHARMACY, L.L.C.
CAH331320-00 Bassett Hospital of Schoharie County dba Cobleskill Regional Hospital
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Covered Entity Details
Entity Name
Bassett Hospital of Schoharie County dba Cobleskill Regional Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH331320-00
Entity Address
178 Grandview Drive
Cobleskill, NY 12043
Medicare Provider Number
331320
Participating Start Date
10/1/2019
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #2819
1309 NW 23RD AVE.
PORTLAND, OR 97210
Pharmacy Comments
Contract Details
Approval Date
4/1/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paul Swinko, CFO
(607) 547-3096
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/1/2021
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