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PROCARE PHARMACY, L.L.C.
CH0530890 NATIVE AMERICAN COMMUNITY CLINIC
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Covered Entity Details
Entity Name
NATIVE AMERICAN COMMUNITY CLINIC
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH0530890
Entity Address
1213 E. FRANKLIN AVENUE
MINNEAPOLIS, MN 55404
Grant Number
H80CS06661
Participating Start Date
7/1/2006
Last Recertification Date
2/17/2025
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
10/10/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kari Rabie, Medical Director
(612) 872-8086 Ext: 1008
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/10/2024
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