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PROCARE PHARMACY, L.L.C.
STD64119 Planned Parenthood Great Plains
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Covered Entity Details
Entity Name
Planned Parenthood Great Plains
Subdivision Name
Northland Health Center
Type
Sexually Transmitted Diseases
340B ID
STD64119
Entity Address
2900 NE 60th Street
Suite 100
Gladstone, MO 64119
Grant Number
NH25PS005142-05-09
Participating Start Date
10/1/2017
Last Recertification Date
5/7/2024
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
1/12/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Emily Wales, President & CEO
(913) 345-4613
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/12/2024
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