Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
RWII802201 Colorado Health Network, Inc.

Covered Entity Details

Entity Name

Colorado Health Network, Inc.

Subdivision Name

Type

Ryan White Part B

340B ID

RWII802201

Entity Address

6260 E. Colfax Ave.
Denver, CO 80220

Grant Number

X07HA00056

Participating Start Date

7/1/2020

Last Recertification Date

2/12/2025

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

7/13/2023

Contract Begin Date

10/1/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Darrell J Vigil, Chief Executive Officer
(303) 837-0166

Contract Pharmacy Representative

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

Signed By Date

7/13/2023

340B Drug Pricing Program Database