Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
RWI381041 Positively Living, Inc.

Covered Entity Details

Entity Name

Positively Living, Inc.

Subdivision Name

Type

Ryan White Part A

340B ID

RWI381041

Entity Address

1331 Union Ave
750H
Memphis, TN 38104

Grant Number

H89HA11464-15-02

Participating Start Date

1/1/2024

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

PROCARE PHARMACY, L.L.C.

Pharmacy Address

CVS/PHARMACY #10994
60 MARKET CENTER DRIVE
SUITE 103
COLLIERVILLE, TN 38017

Pharmacy Comments

Contract Details

Approval Date

1/15/2024

Contract Begin Date

4/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Steve Jenkins, Chief Executive Officer
(865) 556-5217

Contract Pharmacy Representative

CVSHEALTH
ADAM J HORN, ACCOUNT MGR
(773) 610-9315

Signed By Date

1/15/2024

340B Drug Pricing Program Database