Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
STD29302 Piedmont Care, Inc.

Covered Entity Details

Entity Name

Piedmont Care, Inc.

Subdivision Name

Type

Sexually Transmitted Diseases

340B ID

STD29302

Entity Address

101 North Pine St., Suite 200
Spartanburg, SC 29302-1604

Grant Number

NU62PS924641

Participating Start Date

10/1/2020

Last Recertification Date

5/8/2024

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

1/13/2022

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