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PROCARE PHARMACY, L.L.C.
CH10123Q VIRGINIA GARCIA MEMORIAL HEALTH CENTER
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Covered Entity Details
Entity Name
VIRGINIA GARCIA MEMORIAL HEALTH CENTER
Subdivision Name
Virginia Garcia Beaverton School Based Health Center
Type
HRSA-Funded Health Center
340B ID
CH10123Q
Entity Address
13000 SW 2ND ST
BEAVERTON, OR 97005-2615
Grant Number
H80CS00817
Participating Start Date
4/1/2017
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #2819
1309 NW 23RD AVE.
PORTLAND, OR 97210
Pharmacy Comments
Contract Details
Approval Date
10/13/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Annmarie Rainford Dennis, Corporate Compliance Officer
(503) 214-1652
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/13/2023
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