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PROCARE PHARMACY, L.L.C.
STD33016 Doctors United Group Inc
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Covered Entity Details
Entity Name
Doctors United Group Inc
Subdivision Name
Doctors United Group Inc hialeah
Type
Sexually Transmitted Diseases
340B ID
STD33016
Entity Address
2150 W 76th street
suite 100
hialeah, FL 33016
Grant Number
NH25PS004342
Participating Start Date
10/1/2021
Last Recertification Date
5/5/2025
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
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Augustine Carbon, President
(305) 788-0007
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/15/2024
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