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PROCARE PHARMACY, L.L.C.
CHC00495-16 Union Community Care
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Covered Entity Details
Entity Name
Union Community Care
Subdivision Name
Lebanon Urgent Care (Behavioral and Physical Health)
Type
HRSA-Funded Health Center
340B ID
CHC00495-16
Entity Address
960 Church St
Lebanon, PA 17046-4656
Grant Number
H80CS00495
Participating Start Date
4/1/2023
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY # 02553
1117 WALNUT ST.
PHILADELPHIA, PA 19107
Pharmacy Comments
Contract Details
Approval Date
1/17/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Alisa Jones, CEO
(717) 945-1551
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/17/2023
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