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PROCARE PHARMACY DIRECT, L.L.C.
DSH390028 UPMC MERCY
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Covered Entity Details
Entity Name
UPMC MERCY
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH390028
Entity Address
1400 LOCUST STREET
PITTSBURGH, PA 15219
Medicare Provider Number
390028
Participating Start Date
9/2/2008
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY DIRECT, L.L.C.
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
105 MALL BOULEVARD
MONROEVILLE, PA 15146
Pharmacy Comments
12/11/2009 - PHARMACY MOVED FROM 600 PENN CENTER BLVD., PITTSBURGH, PA 15235-5810 AND NAME CHANGE (WAS PROCARE PHARMACY DIRECT, INC DBA PHARMACARE SPECIALTY PHARMACY)
Contract Details
Approval Date
7/19/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Eileen Simmons, Chief Financial Officer
(412) 647-7713
Contract Pharmacy Representative
CVS
Ross Luce, Senior Director, Specialty Product Development
(800) 238-7828
Signed By Date
7/19/2017
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