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PROCARE PHARMACY, L.L.C.
CH09244C Clinic Inc, The
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Covered Entity Details
Entity Name
Clinic Inc, The
Subdivision Name
T.H.E. Clinic at Hawthorne
Type
HRSA-Funded Health Center
340B ID
CH09244C
Entity Address
10321 HAWTHORNE BLVD
INGLEWOOD, CA 90304-1500
Grant Number
H80CS00755
Participating Start Date
4/1/2018
Last Recertification Date
2/20/2025
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
10/9/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Clifford Shiepe, President and CEO
(323) 730-1920 Ext: 3053
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/9/2023
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