Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
CH020110 WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.

Covered Entity Details

Entity Name

WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.

Subdivision Name

WHITNEY M. YOUNG, JR. HEALTH CENTER

Type

HRSA-Funded Health Center

340B ID

CH020110

Entity Address

920 Lark Dr
Albany, NY 12207-1300

Grant Number

H80CS00433

Participating Start Date

10/1/1995

Last Recertification Date

2/14/2025

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

1/14/2022

Contract Begin Date

4/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

David Harold Shippee, President & CEO
(518) 591-4459

Contract Pharmacy Representative

CVS
Kathryn Ficca, Account Manager
(401) 772-7339

Signed By Date

1/14/2022

340B Drug Pricing Program Database