Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
STD32724 Home Of Grace INC

Covered Entity Details

Entity Name

Home Of Grace INC

Subdivision Name

Home Of Grace INC

Type

Sexually Transmitted Diseases

340B ID

STD32724

Entity Address

230 E New York Ave
Deland, FL 32724

Grant Number

H25PS005131

Participating Start Date

7/20/2022

Last Recertification Date

5/13/2024

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

7/27/2022

Contract Begin Date

7/29/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Adaobi Oguchi, President
(407) 402-6324

Contract Pharmacy Representative

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

Signed By Date

7/27/2022

340B Drug Pricing Program Database