Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
CH036640 CHASE BREXTON HEALTH SERVICES, INC

Covered Entity Details

Entity Name

CHASE BREXTON HEALTH SERVICES, INC

Subdivision Name

Chase Brexton Health Services, Inc.

Type

HRSA-Funded Health Center

340B ID

CH036640

Entity Address

1111 North Charles Street
Baltimore, MD 21201-5505

Grant Number

H80CS00734

Participating Start Date

4/1/1997

Last Recertification Date

2/10/2025

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

7/7/2021

Contract Begin Date

10/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Eric Turnbaugh, CFO
(410) 837-2050 Ext: 1148

Contract Pharmacy Representative

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

Signed By Date

7/7/2021

340B Drug Pricing Program Database