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PROCARE PHARMACY, L.L.C.
STD328059 Positive Assistance, Inc.
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Covered Entity Details
Entity Name
Positive Assistance, Inc.
Subdivision Name
Positive Assistance Health Center
Type
Sexually Transmitted Diseases
340B ID
STD328059
Entity Address
750 S. Orange Blossom Trail
Suite 222
Orlando, FL 32805
Grant Number
5NU62PS924532-02
Participating Start Date
7/1/2019
Last Recertification Date
5/15/2024
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
7/14/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Andre J Antenor, President
(863) 242-3322
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/14/2022
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