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PROCARE PHARMACY, L.L.C.
FQHCLA280A Knox/Winamac Community Health Centers, Inc.
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Covered Entity Details
Entity Name
Knox/Winamac Community Health Centers, Inc.
Subdivision Name
Knox/Winamac Community Health Centers
Type
Health Center Program Look-Alike
340B ID
FQHCLA280A
Entity Address
1002 S. Edgewood Dr.
Knox, IN 46534-8226
Grant Number
LALCS00038
Participating Start Date
10/1/2015
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
7/11/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kathy Robb, Executive Director
(574) 772-6030 Ext: 24
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/11/2024
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