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PROCARE PHARMACY, L.L.C.
STD94509 Planned Parenthood: Shasta-Diablo, Inc. DBA Planned Parenthood Northern California
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Covered Entity Details
Entity Name
Planned Parenthood: Shasta-Diablo, Inc. DBA Planned Parenthood Northern California
Subdivision Name
ANTIOCH CENTER
Type
Sexually Transmitted Diseases
340B ID
STD94509
Entity Address
1104 BUCHANAN ROAD
#C10
ANTIOCH, CA 94509-4426
Grant Number
1H25PS005127
Participating Start Date
4/1/2004
Last Recertification Date
5/6/2024
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
9/2/2022
Contract Begin Date
9/12/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Gloria Martinez, Medical Services & Purchasing Manager
(925) 887-5217
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
9/2/2022
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