Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
CH047060 LITTLE RIVER MEDICAL CENTER, INC.

Covered Entity Details

Entity Name

LITTLE RIVER MEDICAL CENTER, INC.

Subdivision Name

LITTLE RIVER MEDICAL CENTER, INC.: MAIN SITE

Type

HRSA-Funded Health Center

340B ID

CH047060

Entity Address

4303 Live Oak Dr.
Little River, SC 29566

Grant Number

H80CS00700

Participating Start Date

12/1/1992

Last Recertification Date

2/16/2025

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

4/3/2023

Contract Begin Date

7/1/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

PAMELA R. DAVIS, CEO
(843) 663-8001

Contract Pharmacy Representative

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

Signed By Date

4/3/2023

340B Drug Pricing Program Database