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PROCARE PHARMACY, L.L.C.
STD347444 Sunshine Specialty Health Outreach Foundation
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Covered Entity Details
Entity Name
Sunshine Specialty Health Outreach Foundation
Subdivision Name
Gastroenterology and Nutrition
Type
Sexually Transmitted Diseases
340B ID
STD347444
Entity Address
901 E Oak Street
Suite C
Kissimmee, FL 34744
Grant Number
5NU62PS9224532-02
Participating Start Date
4/1/2023
Last Recertification Date
5/7/2024
Entity Termination Date
7/1/2025
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
10/2/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/25/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jillian Hall, CEO
(407) 888-5980
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/2/2023
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