Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
STD35233 BIRMINGHAM AIDS OUTREACH INC.

Covered Entity Details

Entity Name

BIRMINGHAM AIDS OUTREACH INC.

Subdivision Name

Magic City Wellness Center

Type

Sexually Transmitted Diseases

340B ID

STD35233

Entity Address

3220 5th Avenue South
Suite 100
Birmingham, AL 35222

Grant Number

5 NH25PS005129-04

Participating Start Date

1/1/2017

Last Recertification Date

5/10/2024

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

4/14/2021

Contract Begin Date

5/26/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

KAREN MUSGROVE, EXECUTIVE DIRECTOR
(205) 322-4197

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