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PROCARE PHARMACY, L.L.C.
DSH100039 BROWARD HEALTH MEDICAL CENTER
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Covered Entity Details
Entity Name
BROWARD HEALTH MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH100039
Entity Address
1600 SOUTH ANDREWS AVE.
FORT LAUDERDALE, FL 33316
Medicare Provider Number
100039
Participating Start Date
7/1/2003
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #2686
560 AMSTERDAM AVE, STE #E
ATLANTA, GA 30306
Pharmacy Comments
Contract Details
Approval Date
7/13/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/9/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Alisa Bert, Interim CFO/VP Financial Operations
(954) 847-7483
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/13/2022
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