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PROCARE PHARMACY, L.L.C.
STD329073 Comprehensive Health Center, LLC
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Covered Entity Details
Entity Name
Comprehensive Health Center, LLC
Subdivision Name
Palm Bay
Type
Sexually Transmitted Diseases
340B ID
STD329073
Entity Address
1270 Malabar Road SE
Palm Bay, FL 32907
Grant Number
NH25P5004342-04-01
Participating Start Date
4/1/2021
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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