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PROCARE PHARMACY, L.L.C.
STD46208 Brothers United, Inc.
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Covered Entity Details
Entity Name
Brothers United, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD46208
Entity Address
1712 N. Meridian St.
Suite 200
Indianapolis, IN 46202
Grant Number
6 NU62PS924556-01-03
Participating Start Date
7/1/2019
Last Recertification Date
5/31/2024
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
1/3/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jasmine A Black, Executive Director
(317) 931-0292
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/3/2024
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