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PROCARE PHARMACY, L.L.C.
DSH450154 Val Verde Regional Medical Center
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Covered Entity Details
Entity Name
Val Verde Regional Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH450154
Entity Address
801 Bedell Avenue
Del Rio, TX 78840
Medicare Provider Number
450154
Participating Start Date
1/1/2012
Last Recertification Date
9/4/2024
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
7/14/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Linda Sue Walker, Chief Executive Officer
(830) 703-1749
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/14/2021
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