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PROCARE PHARMACY, L.L.C.
RWI381041 Positively Living, Inc.
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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
DBA CVS/PHARMACY #2923
3250 HARDEN ST. EXT. SUITE #300
COLUMBIA, SC 29203
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
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