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PROCARE PHARMACY, L.L.C.
DSH330027 NASSAU HEALTH CARE CORPORATION
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Covered Entity Details
Entity Name
NASSAU HEALTH CARE CORPORATION
Subdivision Name
Nassau University Medical Center
Type
Disproportionate Share Hospital
340B ID
DSH330027
Entity Address
2201 HEMPSTEAD TURNPIKE
EAST MEADOW, NY 11554
Medicare Provider Number
330027
Participating Start Date
1/1/2004
Last Recertification Date
8/12/2024
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
4/13/2022
Contract Begin Date
4/28/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard J Rank, Director of Finance
(516) 296-2124
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/13/2022
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