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PROCARE PHARMACY, L.L.C.
CH0911100 SAN DIEGO FAMILY CARE
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Covered Entity Details
Entity Name
SAN DIEGO FAMILY CARE
Subdivision Name
LINDA VISTA HEALTH CARE CENTER
Type
HRSA-Funded Health Center
340B ID
CH0911100
Entity Address
6973 Linda Vista Rd
San Diego, CA 92111-6342
Grant Number
H80CS02319
Participating Start Date
4/1/1996
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY OR CARELONRX SPECIALTY
ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1
HONOLULU, HI 96813
Pharmacy Comments
3/22/10 NAME CORRECTION (WAS CVS PROCARE PHARMACY DBA CVS PROCARE PHARMACY #2915) 3/17/10 ADDR CHANGE (WAS 970 N KALAHEO AVE, SUITE A 203)
Contract Details
Approval Date
4/14/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ROBERTA L. FEINBERG, CHIEF EXECUTIVE OFFICER
(858) 279-9676
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/14/2022
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