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PROCARE PHARMACY, L.L.C.
STD770361 AIDS Foundation Houston, Inc.
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Covered Entity Details
Entity Name
AIDS Foundation Houston, Inc.
Subdivision Name
FLAS
Type
Sexually Transmitted Diseases
340B ID
STD770361
Entity Address
6666 Harwin Drive
370
Houston, TX 77036
Grant Number
1 NU62PS924685-01-00
Participating Start Date
7/1/2019
Last Recertification Date
5/13/2022
Entity Termination Date
10/1/2022
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
4/7/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2022
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Nicholas Williams, CFO
(713) 623-6796 Ext: 285
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/7/2021
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