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PROCARE PHARMACY, L.L.C.
CH062350 IBERIA COMPRHESIVE COM HEALTH CNTR, INC.
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Covered Entity Details
Entity Name
IBERIA COMPRHESIVE COM HEALTH CNTR, INC.
Subdivision Name
IBERIA COMPREHENSIVE COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH062350
Entity Address
806 Jefferson Ter
New Iberia, LA 70560-5727
Grant Number
H80CS00697
Participating Start Date
12/1/1992
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY OR CARELONRX SPECIALTY
ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1
HONOLULU, HI 96813
Pharmacy Comments
3/22/10 NAME CORRECTION (WAS CVS PROCARE PHARMACY DBA CVS PROCARE PHARMACY #2915) 3/17/10 ADDR CHANGE (WAS 970 N KALAHEO AVE, SUITE A 203)
Contract Details
Approval Date
1/17/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
RODERICK C. CAMPBELL, CEO
(337) 365-4945 Ext: 128
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/17/2023
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