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PROCARE PHARMACY, L.L.C.
STD328087 Comprehensive Health Center, LLC
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Covered Entity Details
Entity Name
Comprehensive Health Center, LLC
Subdivision Name
Comprehensive Health Of Orlando
Type
Sexually Transmitted Diseases
340B ID
STD328087
Entity Address
1011 W Oakridge Road
Orlando, FL 32809
Grant Number
NH25P5004342-04-01
Participating Start Date
10/1/2018
Last Recertification Date
5/7/2024
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
7/1/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mary Ballantine, Executive Director
(305) 688-0811
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/1/2021
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