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PROCARE PHARMACY, L.L.C.
CH0627800 GREAT SALT PLAINS HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
GREAT SALT PLAINS HEALTH CENTER, INC.
Subdivision Name
Great Salt Plains Health Center
Type
HRSA-Funded Health Center
340B ID
CH0627800
Entity Address
405 S. Oklahoma Ave
Cherokee, OK 73728-2545
Grant Number
H80CS08744
Participating Start Date
4/1/2008
Last Recertification Date
2/11/2025
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
10/1/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
TIM STARKEY, CEO/EXECUTIVE DIRECTOR
(580) 596-2800
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/1/2024
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