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PROCARE PHARMACY, L.L.C.
STD15301 Central Outreach Wellness Center, LLC
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Covered Entity Details
Entity Name
Central Outreach Wellness Center, LLC
Subdivision Name
Central Outreach Wellness Center, LLC South Office
Type
Sexually Transmitted Diseases
340B ID
STD15301
Entity Address
817 Jefferson Avenue
Washington, PA 15301
Grant Number
NH25PS005144
Participating Start Date
4/1/2018
Last Recertification Date
5/7/2024
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
Stacy Lane, Owner
(412) 608-8313
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/14/2022
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