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PROCARE PHARMACY, L.L.C.
CAH301308-00 VALLEY REGIONAL HOSPITAL
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Covered Entity Details
Entity Name
VALLEY REGIONAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH301308-00
Entity Address
243 ELM STREET
CLAREMONT, NH 03743
Medicare Provider Number
301308
Participating Start Date
4/1/2011
Last Recertification Date
9/3/2024
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
10/15/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jean Shaw, CHIEF FINANCIAL OFFICER
(603) 542-3421
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2021
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