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PROCARE PHARMACY, L.L.C.
FQHCLA476D COMMUNITY HEALTHNET INC
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Covered Entity Details
Entity Name
COMMUNITY HEALTHNET INC
Subdivision Name
Community HealthNet Main
Type
Health Center Program Look-Alike
340B ID
FQHCLA476D
Entity Address
1021 W 5th Ave
Gary, IN 46402-1703
Grant Number
LALCS53695
Participating Start Date
1/1/2025
Last Recertification Date
2/13/2025
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
10/18/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Janet Seabrook, CEO
(219) 484-2442
Contract Pharmacy Representative
CVS Pharmacies
Christian Reid, 340B Program Director
(401) 770-2118
Signed By Date
10/15/2024
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