Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
CH01241C STAYWELL HEALTH CARE, INC.

Covered Entity Details

Entity Name

STAYWELL HEALTH CARE, INC.

Subdivision Name

STAYWELL HEALTH CARE, INC.

Type

HRSA-Funded Health Center

340B ID

CH01241C

Entity Address

80 PHOENIX AVE
WATERBURY, CT 06702-1418

Grant Number

H80CS00350

Participating Start Date

1/1/2004

Last Recertification Date

2/12/2025

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

7/14/2021

Contract Begin Date

10/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Donald Thompson, CEO
(203) 756-8021 Ext: 3016

Contract Pharmacy Representative

CVS
Christian Reid, 340B Program Director, CVS Pharmacy
(401) 770-2118

Signed By Date

7/14/2021

340B Drug Pricing Program Database