Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
CH045800 GOSHEN MEDICAL CENTER, INC.

Covered Entity Details

Entity Name

GOSHEN MEDICAL CENTER, INC.

Subdivision Name

GOSHEN MEDICAL CENTER, INC.

Type

HRSA-Funded Health Center

340B ID

CH045800

Entity Address

444 SW Center St
Faison, NC 28341

Grant Number

H80CS00181

Participating Start Date

7/1/2003

Last Recertification Date

3/10/2025

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

1/17/2023

Contract Begin Date

4/1/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Robin Harrell Smith, Pharmacy Site Leader/Technician
(910) 718-5200

Contract Pharmacy Representative

Goshen Medical Center, Inc.
Brooke Cottle Hall, Pharmacy Program Manager
(910) 267-0421 Ext: 1139

Signed By Date

1/17/2023

340B Drug Pricing Program Database