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PROCARE PHARMACY, L.L.C.
STD379171 Positively Living
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Covered Entity Details
Entity Name
Positively Living
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD379171
Entity Address
1925 Ailor Ave
Knoxville, TN 37921
Grant Number
1NU65PS923764-01-00
Participating Start Date
4/1/2018
Last Recertification Date
5/9/2024
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
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Steve Jenkins, Chief Executive Officer
(865) 556-5217
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/15/2021
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