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PROCARE PHARMACY, L.L.C.
RRC050145-00 COMMUNITY HOSP. MONTEREY PENINSULA
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Covered Entity Details
Entity Name
COMMUNITY HOSP. MONTEREY PENINSULA
Subdivision Name
Type
Rural Referral Center
340B ID
RRC050145-00
Entity Address
23625 HOLMAN HWY
MONTEREY, CA 93940
Medicare Provider Number
050145
Participating Start Date
4/1/2024
Last Recertification Date
9/23/2024
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
10/15/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Matthew Thomas Morgan, CFO
(831) 625-4965
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2024
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