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PROCARE PHARMACY, L.L.C.
STD72209 Arkansas RAPPS, Inc.
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Covered Entity Details
Entity Name
Arkansas RAPPS, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD72209
Entity Address
8615 Chicot Road
Little Rock, AR 72209
Grant Number
NH25PS005132-05-0
Participating Start Date
8/16/2021
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #2751
426 S. HENDERSON STREET
FORT WORTH, TX 76104
Pharmacy Comments
Contract Details
Approval Date
10/11/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Cornelius Mabin, CEO
(501) 379-8357
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/11/2023
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