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PROCARE PHARMACY, L.L.C.
STD44118 Central Outreach Wellness Center
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Covered Entity Details
Entity Name
Central Outreach Wellness Center
Subdivision Name
Central Outreach Wellness Center Cleveland Heights
Type
Sexually Transmitted Diseases
340B ID
STD44118
Entity Address
2040 Lee Road
Cleveland Heights, OH 44118
Grant Number
NH25PS005134
Participating Start Date
10/1/2021
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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