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PROCARE PHARMACY, L.L.C.
STD330122 Allied Health Organization INC
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Covered Entity Details
Entity Name
Allied Health Organization INC
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD330122
Entity Address
3762 W 12 Avenue
Hialeah, FL 33012-0000
Grant Number
NH25PS005131
Participating Start Date
8/3/2020
Last Recertification Date
6/6/2022
Entity Termination Date
7/1/2023
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
5/21/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Alejandro J Castro, CEO
(954) 446-3204
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
5/21/2021
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