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PROCARE PHARMACY, L.L.C.
RW424791 Central Carolina Health Network
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Covered Entity Details
Entity Name
Central Carolina Health Network
Subdivision Name
Type
Ryan White Part D
340B ID
RW424791
Entity Address
1 Centerview Drive
Suite 202
Greensboro, NC 27407
Grant Number
H12HA24791
Participating Start Date
4/1/2015
Last Recertification Date
2/20/2025
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
10/1/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Chavanne Lamb, President & CEO
(336) 292-0665
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/1/2021
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