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PROCARE PHARMACY, L.L.C.
STD33308 Light Of Hope, Inc.
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Covered Entity Details
Entity Name
Light Of Hope, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33308
Entity Address
3012 E Commercial Blvd.
Fort Lauderdale, FL 33308
Grant Number
NH25PS004342
Participating Start Date
7/1/2019
Last Recertification Date
5/6/2024
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
1/23/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Stephen A Renae, Medical Director
(954) 776-9992 Ext: 100
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/17/2023
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