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PROCARE PHARMACY, L.L.C.
CAN050660-00 USC Norris Cancer Hospital
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Covered Entity Details
Entity Name
USC Norris Cancer Hospital
Subdivision Name
Type
Free Standing Cancer Hospital
340B ID
CAN050660-00
Entity Address
1441 Eastlake Avenue
Los Angeles, CA 90033
Medicare Provider Number
050660
Participating Start Date
1/1/2014
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY #2909
1521 4TH AVE., SOUTH
BIRMINGHAM, AL 35233
Pharmacy Comments
Contract Details
Approval Date
10/15/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rod Hanners, Chief Operating Officer
(323) 442-8677
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2021
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