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PROCARE PHARMACY DIRECT, L.L.C.
FQHCLA397 Health Service Alliance
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Covered Entity Details
Entity Name
Health Service Alliance
Subdivision Name
Chino Valley Community Health Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA397
Entity Address
13193 Central Ave STE 100
Chino, CA 91710
Grant Number
LALCS33333
Participating Start Date
10/1/2019
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY DIRECT, L.L.C.
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
105 MALL BOULEVARD
MONROEVILLE, PA 15146
Pharmacy Comments
12/11/2009 - PHARMACY MOVED FROM 600 PENN CENTER BLVD., PITTSBURGH, PA 15235-5810 AND NAME CHANGE (WAS PROCARE PHARMACY DIRECT, INC DBA PHARMACARE SPECIALTY PHARMACY)
Contract Details
Approval Date
4/15/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jeff Cox, Chief Executive Officer
(909) 784-6117
Contract Pharmacy Representative
CVSHEALTH
ADAM J HORN, ACCOUNT MGR
(773) 610-9315
Signed By Date
4/15/2024
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