Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
STD329072 Healthy MD Clinical, LLC (f.k.a. Independent Medical Group, LLC)

Covered Entity Details

Entity Name

Healthy MD Clinical, LLC (f.k.a. Independent Medical Group, LLC)

Subdivision Name

Palm Bay

Type

Sexually Transmitted Diseases

340B ID

STD329072

Entity Address

7436 S Federal Highway
Port St Lucie, FL 34952

Grant Number

NH25PS004342-04-01

Participating Start Date

1/1/2021

Last Recertification Date

5/6/2024

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

7/14/2024

Contract Begin Date

10/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Steve Vixamar, COO
(954) 529-1178

Contract Pharmacy Representative

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

Signed By Date

7/14/2024

340B Drug Pricing Program Database