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PROCARE PHARMACY, L.L.C.
CAH331311-00 Little Falls Hospital
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Covered Entity Details
Entity Name
Little Falls Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH331311-00
Entity Address
140 Burwell Street
Little Falls, NY 13365
Medicare Provider Number
331311
Participating Start Date
2/13/2013
Last Recertification Date
8/29/2024
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
4/2/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
James Vielkind, CFO
(315) 823-5281
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/2/2021
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