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PROCARE PHARMACY, L.L.C.
STD33169 ALIVE and WELL COMMUNITY PARTNERS
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Covered Entity Details
Entity Name
ALIVE and WELL COMMUNITY PARTNERS
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33169
Entity Address
18425 N.W. 2ND AVENUE
5TH FLOOR
PH-7
MIAMI, FL 33169
Grant Number
NH25PS005131
Participating Start Date
1/1/2020
Last Recertification Date
5/25/2024
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
5/13/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/31/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Steve Taylor, CFO/OPERATIONS OFFICER
(800) 434-1366 Ext: 1000
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/14/2021
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