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PROCARE PHARMACY, L.L.C.
CHC12845-00 NATIVE HEALTH
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Covered Entity Details
Entity Name
NATIVE HEALTH
Subdivision Name
NATIVE HEALTH West 8800
Type
HRSA-Funded Health Center
340B ID
CHC12845-00
Entity Address
8800 N 22nd Ave
Phoenix, AZ 85021
Grant Number
H80CS12845
Participating Start Date
4/1/2012
Last Recertification Date
2/19/2025
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
7/2/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Walter Murillo, Chief Executive Officer
(602) 279-5262
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/2/2024
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