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PROCARE PHARMACY, L.L.C.
CH010810 South-West Community Health Center, Inc.
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Covered Entity Details
Entity Name
South-West Community Health Center, Inc.
Subdivision Name
SOUTHWEST COMMUNITY HLTH CTR, INC
Type
HRSA-Funded Health Center
340B ID
CH010810
Entity Address
46 Albion St
Bridgeport, CT 06605-2602
Grant Number
H80CS00613
Participating Start Date
1/1/2004
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY# 11235
9555 KINGS CHARTER DR., SUITE D
ASHLAND, VA 23005
Pharmacy Comments
Contract Details
Approval Date
1/10/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/13/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Mollie Melbourne, President/CEO
(203) 332-3501
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/10/2022
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