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PROCARE PHARMACY, L.L.C.
STD331501 Doctors United group
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Covered Entity Details
Entity Name
Doctors United group
Subdivision Name
62nd
Type
Sexually Transmitted Diseases
340B ID
STD331501
Entity Address
714 NW 62nd street
Miami, FL 33150
Grant Number
NH25PS004342
Participating Start Date
1/1/2022
Last Recertification Date
5/13/2024
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
6/7/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/9/2022
Agreement registered in error
Contacts
Covered Entity Signing Official
Augustine Carbon, President
(305) 788-0007
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
6/7/2022
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