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PROCARE PHARMACY, L.L.C.
PED393302-00 UPMC CHILDREN'S HOSPITAL OF PITTSBURGH
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Covered Entity Details
Entity Name
UPMC CHILDREN'S HOSPITAL OF PITTSBURGH
Subdivision Name
Type
Children's Hospital
340B ID
PED393302-00
Entity Address
4401 PENN AVENUE
PITTSBURGH, PA 15224
Medicare Provider Number
393302
Participating Start Date
1/1/2010
Last Recertification Date
9/6/2024
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
4/13/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mario Edward Wilfong, CFO
(412) 692-8201
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/13/2021
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