Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
RWI900271 AIDS HEALTHCARE FOUNDATION

Covered Entity Details

Entity Name

AIDS HEALTHCARE FOUNDATION

Subdivision Name

AHF HEALTHCARE CENTER - HOLLYWOOD

Type

Ryan White Part A

340B ID

RWI900271

Entity Address

4905 Hollywood Blvd.
LOS ANGELES, CA 90027

Grant Number

H89HA00016

Participating Start Date

7/1/2005

Last Recertification Date

2/20/2025

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

7/13/2022

Contract Begin Date

10/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Rena DeStefano, Director of Pharmacy Finance
(631) 370-2022

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

7/13/2022

340B Drug Pricing Program Database