Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
FQHCLA434D MOUNTAIN AREA HEALTH EDUCATION CENTER, INC.

Covered Entity Details

Entity Name

MOUNTAIN AREA HEALTH EDUCATION CENTER, INC.

Subdivision Name

MAHEC Cane Creek Primary Care Center

Type

Health Center Program Look-Alike

340B ID

FQHCLA434D

Entity Address

1542 Cane Creek Rd
Fletcher, NC 28732-7423

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

340B Drug Pricing Program Database