340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PROCARE PHARMACY, L.L.C.
FQHCLA311 Greater Fresno Health Organization
Print
Covered Entity Details
Entity Name
Greater Fresno Health Organization
Subdivision Name
Kings Winery Medical Clinic
Type
Health Center Program Look-Alike
340B ID
FQHCLA311
Entity Address
4929 E Cesar Chavez Blvd
Fresno, CA 93727-3812
Grant Number
LALCS00041
Participating Start Date
10/1/2018
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY #2909
1521 4TH AVE., SOUTH
BIRMINGHAM, AL 35233
Pharmacy Comments
Contract Details
Approval Date
7/5/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
BLA MOUANOUTOUA, CEO
(559) 255-6476 Ext: 4290
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/5/2023
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session