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PROCARE PHARMACY, L.L.C.
CH092080 ALLIANCE MEDICAL CENTER, INC.
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Covered Entity Details
Entity Name
ALLIANCE MEDICAL CENTER, INC.
Subdivision Name
ALLIANCE MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH092080
Entity Address
1381 UNIVERSITY AVENUE
HEALDSBURG, CA 95448-3314
Grant Number
H80CS00249
Participating Start Date
4/1/1996
Last Recertification Date
2/18/2025
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
10/3/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Susannah Labbe, CEO
(707) 480-3898
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/3/2023
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