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PROCARE PHARMACY, L.L.C.
STD328041 ALLIED HEALTH ORGANIZATION INC
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Covered Entity Details
Entity Name
ALLIED HEALTH ORGANIZATION INC
Subdivision Name
Orlando Location
Type
Sexually Transmitted Diseases
340B ID
STD328041
Entity Address
6889 W Colonial Drive # 28
Orlando, FL 32804-0000
Grant Number
NH25PS005131
Participating Start Date
8/3/2020
Last Recertification Date
Entity Termination Date
7/1/2021
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
7/1/2021
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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