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PROCARE PHARMACY, L.L.C.
STD33487 Life Resources LLC
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Covered Entity Details
Entity Name
Life Resources LLC
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33487
Entity Address
1157 S. State Road 7
Wellington, FL 33414
Grant Number
NH25PS004342
Participating Start Date
4/1/2021
Last Recertification Date
5/6/2024
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
6/2/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jon Arenstein, CEO
(561) 234-6599
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/15/2021
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