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PROCARE PHARMACY, L.L.C.
FQHC638005A GREENVILLE RANCHERIA TRIBAL HEALTH
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Covered Entity Details
Entity Name
GREENVILLE RANCHERIA TRIBAL HEALTH
Subdivision Name
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638005A
Entity Address
1425 MONTGOMERY ROAD
RED BLUFF, CA 96080
Grant Number
Participating Start Date
7/1/2016
Last Recertification Date
2/10/2025
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
10/8/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tracy Remick, CEO
(530) 528-8600 Ext: 242
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/8/2024
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