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PROCARE PHARMACY, L.L.C.
DSH390028 UPMC MERCY
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Covered Entity Details
Entity Name
UPMC MERCY
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH390028
Entity Address
1400 LOCUST STREET
PITTSBURGH, PA 15219
Medicare Provider Number
390028
Participating Start Date
9/2/2008
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY OR CARELONRX SPECIALTY
ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1
HONOLULU, HI 96813
Pharmacy Comments
3/22/10 NAME CORRECTION (WAS CVS PROCARE PHARMACY DBA CVS PROCARE PHARMACY #2915) 3/17/10 ADDR CHANGE (WAS 970 N KALAHEO AVE, SUITE A 203)
Contract Details
Approval Date
1/12/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jonathan Petrie, CFO UPMC Magee and Mercy
(412) 578-9416
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/12/2024
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