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PROCARE PHARMACY, L.L.C.
STD761101 Health Education Learning Project
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Covered Entity Details
Entity Name
Health Education Learning Project
Subdivision Name
8th Avenue
Type
Sexually Transmitted Diseases
340B ID
STD761101
Entity Address
1919 8th Avenue
Fort Worth, TX 76110
Grant Number
NH25PS005182
Participating Start Date
10/1/2019
Last Recertification Date
5/14/2024
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
1/11/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
DeeJay Johannessen, Chief Executive Officer
(817) 332-7722
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/11/2022
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