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PROCARE PHARMACY DIRECT, L.L.C.
DSH050291 Sutter Bay Hospitals, dba Sutter Santa Rosa Regional Hospital
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Covered Entity Details
Entity Name
Sutter Bay Hospitals, dba Sutter Santa Rosa Regional Hospital
Subdivision Name
dba Sutter Santa Rosa Regional Hospital
Type
Disproportionate Share Hospital
340B ID
DSH050291
Entity Address
30 MARK WEST SPRINGS ROAD
SANTA ROSA, CA 95403
Medicare Provider Number
050291
Participating Start Date
7/1/2005
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY DIRECT, L.L.C.
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
105 MALL BOULEVARD
MONROEVILLE, PA 15146
Pharmacy Comments
12/11/2009 - PHARMACY MOVED FROM 600 PENN CENTER BLVD., PITTSBURGH, PA 15235-5810 AND NAME CHANGE (WAS PROCARE PHARMACY DIRECT, INC DBA PHARMACARE SPECIALTY PHARMACY)
Contract Details
Approval Date
10/18/2022
Contract Begin Date
11/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Dan Peterson, Chief Executive Officer
(707) 576-4564
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/18/2022
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