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PROCARE PHARMACY, L.L.C.
CH08126B Mountain Family Health Centers
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Covered Entity Details
Entity Name
Mountain Family Health Centers
Subdivision Name
Mountain Family Health Centers Glenwood Springs
Type
HRSA-Funded Health Center
340B ID
CH08126B
Entity Address
1905 BLAKE AVE
STE 101
GLENWOOD SPRINGS, CO 81601-4206
Grant Number
H80CS00830
Participating Start Date
10/1/1999
Last Recertification Date
2/11/2025
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
4/4/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rachel Illias, Pharmacy Director
(970) 945-2840 Ext: 7230
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/4/2023
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