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PROCARE PHARMACY, L.L.C.
STD33055 Benevolence Medical Services,Inc
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Covered Entity Details
Entity Name
Benevolence Medical Services,Inc
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33055
Entity Address
19533 NW 57th ave
miami gardens, FL 33055
Grant Number
5nu62ps924532
Participating Start Date
10/1/2023
Last Recertification Date
5/13/2024
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
4/12/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Arshad Ali Mohammed, DIRECTOR
(786) 863-5539
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/12/2024
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