Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
CH04168D FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.

Covered Entity Details

Entity Name

FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.

Subdivision Name

FORT MYERS CENTER - DOWNTOWN

Type

HRSA-Funded Health Center

340B ID

CH04168D

Entity Address

2232 GRAND AVE
FORT MYERS, FL 33901-3717

Grant Number

H80CS00185

Participating Start Date

4/1/1995

Last Recertification Date

3/4/2025

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

4/14/2021

Contract Begin Date

7/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Carrie Poulsom, VP & Chief Pharmacy Officer
(239) 344-2321

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

4/14/2021

340B Drug Pricing Program Database