Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
RWI30058B AIDS Healthcare Foundation

Covered Entity Details

Entity Name

AIDS Healthcare Foundation

Subdivision Name

AHF Healthcare Center - Auburn

Type

Ryan White Part A

340B ID

RWI30058B

Entity Address

659 Auburn Ave NE Ste 156
Atlanta, GA 30312

Grant Number

H89HA00007

Participating Start Date

6/10/2022

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

PROCARE PHARMACY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY #2909
1521 4TH AVE., SOUTH
BIRMINGHAM, AL 35233

Pharmacy Comments

Contract Details

Approval Date

1/16/2024

Contract Begin Date

4/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Rena DeStefano, Director of Pharmacy Finance
(631) 370-2022

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

1/16/2024

340B Drug Pricing Program Database