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PROCARE PHARMACY, L.L.C.
STD336052 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Ybor
Type
Sexually Transmitted Diseases
340B ID
STD336052
Entity Address
2105 N Nebraska Ave
Tampa, FL 33602
Grant Number
1 NH25PS005131-01-00
Participating Start Date
1/1/2016
Last Recertification Date
5/27/2024
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
10/18/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rishi Patel, President & CEO
(941) 300-4440 Ext: 11127
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/18/2021
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