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PROCARE PHARMACY, L.L.C.
STD27403 Triad Health Project
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Covered Entity Details
Entity Name
Triad Health Project
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD27403
Entity Address
801 Summit Avenue
Greensboro, NC 27405
Grant Number
6 NH25PS005152-02-01
Participating Start Date
4/1/2021
Last Recertification Date
5/14/2024
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
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Adriana Elise Galdo Adams, Executive Director
(336) 275-1654
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/16/2023
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