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PROCARE PHARMACY, L.L.C.
FQHCLA434E MOUNTAIN AREA HEALTH EDUCATION CENTER, INC.
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Covered Entity Details
Entity Name
MOUNTAIN AREA HEALTH EDUCATION CENTER, INC.
Subdivision Name
MAHEC Family Health Center at Deerfield
Type
Health Center Program Look-Alike
340B ID
FQHCLA434E
Entity Address
29 Highbridge Xing
Asheville, NC 28803-3496
Grant Number
LALCS45788
Participating Start Date
10/1/2022
Last Recertification Date
2/12/2025
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
10/7/2022
Contract Begin Date
11/15/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
William R Hathaway, CEO
(828) 257-4405
Contract Pharmacy Representative
Wellpartner
Kenneth Bodmer, Vice President
(877) 805-9483
Signed By Date
10/7/2022
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