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PROCARE PHARMACY, L.L.C.
STD705703 Acadiana Practitioners' Gastro Clinic
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Covered Entity Details
Entity Name
Acadiana Practitioners' Gastro Clinic
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD705703
Entity Address
331 South Main Street
Opelousas, LA 70570
Grant Number
NH25PS005176
Participating Start Date
7/1/2025
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
5/2/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/2/2025
Agreement registered in error
Contacts
Covered Entity Signing Official
Rhonda Bergeron, CEO
(337) 447-4027
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/9/2025
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