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PROCARE PHARMACY, L.L.C.
DSH220019 UMass Memorial Health - Harrington Hospital, Inc.
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Covered Entity Details
Entity Name
UMass Memorial Health - Harrington Hospital, Inc.
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH220019
Entity Address
100 SOUTH STREET
SOUTHBRIDGE, MA 01550
Medicare Provider Number
220019
Participating Start Date
7/1/2009
Last Recertification Date
9/9/2024
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
7/20/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Edward Moore, President
(508) 765-3002
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/20/2023
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