Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
DSH220031 BOSTON MEDICAL CENTER

Covered Entity Details

Entity Name

BOSTON MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH220031

Entity Address

1 Boston Medical Center Place
BOSTON, MA 02118

Medicare Provider Number

220031

Participating Start Date

12/1/1992

Last Recertification Date

8/21/2024

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

4/20/2021

Contract Begin Date

7/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Kathleen E. Walsh, Chief Executive Officer
(617) 638-6911

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

4/20/2021

340B Drug Pricing Program Database