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PROCARE PHARMACY, L.L.C.
STD94610 Oakland LGBTQ Community Center
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Covered Entity Details
Entity Name
Oakland LGBTQ Community Center
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD94610
Entity Address
3207 Lakeshore Ave
Oakland, CA 94610
Grant Number
1H25PS005127
Participating Start Date
4/1/2023
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
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/20/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Maurice Tobin, Testing And Treatment Manager
(510) 882-2286
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/15/2024
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