Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
CHC28956-00 Valle Del Sol, Inc.

Covered Entity Details

Entity Name

Valle Del Sol, Inc.

Subdivision Name

Valle del Sol_3807

Type

HRSA-Funded Health Center

340B ID

CHC28956-00

Entity Address

3807 N 7th St
Phoenix, AZ 85014-5005

Grant Number

H80CS28956

Participating Start Date

1/1/2022

Last Recertification Date

2/17/2025

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

1/13/2023

Contract Begin Date

4/1/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Carmen Heredia, Chief Executive Officer
(602) 258-6797 Ext: 1320

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

1/13/2023

340B Drug Pricing Program Database