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PROCARE PHARMACY, L.L.C.
STD334833 Medical Essentials, LLC
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Covered Entity Details
Entity Name
Medical Essentials, LLC
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD334833
Entity Address
306 W Mango Street
Lantana, FL 33462
Grant Number
5NU62PS92453202
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
9/22/2022
Contract Begin Date
9/23/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Leslie Bravo, CEO
(954) 297-9802
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
9/22/2022
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