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PROCARE PHARMACY DIRECT, L.L.C.
DSH010058 BIBB MEDICAL CENTER
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Covered Entity Details
Entity Name
BIBB MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH010058
Entity Address
208 PIERSON AVENUE
CENTREVILLE, AL 35042
Medicare Provider Number
010058
Participating Start Date
7/1/2017
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY DIRECT, L.L.C.
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
105 MALL BOULEVARD
MONROEVILLE, PA 15146
Pharmacy Comments
12/11/2009 - PHARMACY MOVED FROM 600 PENN CENTER BLVD., PITTSBURGH, PA 15235-5810 AND NAME CHANGE (WAS PROCARE PHARMACY DIRECT, INC DBA PHARMACARE SPECIALTY PHARMACY)
Contract Details
Approval Date
4/10/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Joseph Marchant, CEO
(205) 926-3361
Contract Pharmacy Representative
Bibb Medical Center Pharmacy
Jennifer Guthrie, Pharmacy Director
(205) 926-3277
Signed By Date
4/10/2023
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