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PROCARE PHARMACY, L.L.C.
STD33021 Community Care Resources Inc
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Covered Entity Details
Entity Name
Community Care Resources Inc
Subdivision Name
Community Care Resources of FL
Type
Sexually Transmitted Diseases
340B ID
STD33021
Entity Address
1008 W Hallandale Beach Boulevard
Hallandale, FL 33009
Grant Number
NH25PS005131
Participating Start Date
4/1/2020
Last Recertification Date
5/7/2024
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
4/15/2021
Contract Begin Date
4/23/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Victoria Barnhart, Director
(954) 362-5432
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/15/2021
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