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PROCARE PHARMACY, L.L.C.
DSH070011 CHARLOTTE HUNGERFORD HOSPITAL
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Covered Entity Details
Entity Name
CHARLOTTE HUNGERFORD HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH070011
Entity Address
540 LITCHFIELD STREET
TORRINGTON, CT 06790-0988
Medicare Provider Number
070011
Participating Start Date
4/1/2025
Last Recertification Date
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
1/15/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Cheryl Considine, Director Finance, NW Region
(860) 496-6740
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/10/2025
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