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PROCARE PHARMACY, L.L.C.
STD347411 26Health, Inc.
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Covered Entity Details
Entity Name
26Health, Inc.
Subdivision Name
West Orange Nephrology, LLC
Type
Sexually Transmitted Diseases
340B ID
STD347411
Entity Address
1975 S. John Young Pkwy
101
Kissimmee, FL 34741
Grant Number
1H25PS004342-02
Participating Start Date
1/1/2019
Last Recertification Date
5/4/2020
Entity Termination Date
7/1/2021
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
Contract Termination Date
Termination Reason
7/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
David Baker-Hargrove, President/Co-CEO
(321) 800-2922
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/13/2021
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