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PROCARE PHARMACY, L.L.C.
STD331612 Latinos Salud, Inc.
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Covered Entity Details
Entity Name
Latinos Salud, Inc.
Subdivision Name
North Miami
Type
Sexually Transmitted Diseases
340B ID
STD331612
Entity Address
640 NE 124th Street
North Miami, FL 33161
Grant Number
5 NU62PS924749-02-00
Participating Start Date
1/1/2023
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
11/28/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Stephen Fallon, PhD, Executive Director
(786) 310-3152
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/5/2022
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