Contract Pharmacy Details

PROCARE PHARMACY DIRECT, L.L.C.
RRC450801-00 CHRISTUS ST MICHAEL

Covered Entity Details

Entity Name

CHRISTUS ST MICHAEL

Subdivision Name

Type

Rural Referral Center

340B ID

RRC450801-00

Entity Address

2600 ST MICHAEL DRIVE
TEXARKANA, TX 75503

Medicare Provider Number

450801

Participating Start Date

1/1/2025

Last Recertification Date

Entity Termination Date

1/1/2025

Pharmacy Details

Pharmacy Name

PROCARE PHARMACY DIRECT, L.L.C.

Pharmacy Address

DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
105 MALL BOULEVARD
MONROEVILLE, PA 15146

Pharmacy Comments

12/11/2009 - PHARMACY MOVED FROM 600 PENN CENTER BLVD., PITTSBURGH, PA 15235-5810 AND NAME CHANGE (WAS PROCARE PHARMACY DIRECT, INC DBA PHARMACARE SPECIALTY PHARMACY)

Contract Details

Approval Date

10/23/2024

Contract Begin Date

1/1/2025

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2025
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Jason Adams, President
(903) 614-2001

Contract Pharmacy Representative

Caremark L.L.C.
Christian reid, 340b Program Director
(401) 770-2118

Signed By Date

10/7/2024

340B Drug Pricing Program Database