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PROCARE PHARMACY, L.L.C.
CH02151AJ Sun River Health, Inc.
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Covered Entity Details
Entity Name
Sun River Health, Inc.
Subdivision Name
Harmony Healthcare Long Island at Hempstead
Type
HRSA-Funded Health Center
340B ID
CH02151AJ
Entity Address
619 Fulton Avenue
104
Hempstead, NY 11550-1153
Grant Number
H80CS00313
Participating Start Date
4/1/2014
Last Recertification Date
2/24/2025
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
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Allison Dubois, COO
(914) 734-8600 Ext: 78503
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/16/2023
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