Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
RWII29302 Piedmont Care, Inc.

Covered Entity Details

Entity Name

Piedmont Care, Inc.

Subdivision Name

Type

Ryan White Part B

340B ID

RWII29302

Entity Address

101 North Pine Street, Suite 200
Spartanburg, SC 29302

Grant Number

X07HA00038

Participating Start Date

1/1/2014

Last Recertification Date

2/10/2025

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

1/13/2022

Contract Begin Date

4/1/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/8/2022
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Tracey L. Jackson, Executive Director
(864) 582-7773 Ext: 8642744178

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

1/13/2022

340B Drug Pricing Program Database