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PROCARE PHARMACY DIRECT, L.L.C.
RRC300012-00 ELLIOT HOSPITAL
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Covered Entity Details
Entity Name
ELLIOT HOSPITAL
Subdivision Name
Type
Rural Referral Center
340B ID
RRC300012-00
Entity Address
1 ELLIOT WAY
MANCHESTER, NH 03103
Medicare Provider Number
300012
Participating Start Date
10/1/2024
Last Recertification Date
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY DIRECT, L.L.C.
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
105 MALL BOULEVARD
MONROEVILLE, PA 15146
Pharmacy Comments
12/11/2009 - PHARMACY MOVED FROM 600 PENN CENTER BLVD., PITTSBURGH, PA 15235-5810 AND NAME CHANGE (WAS PROCARE PHARMACY DIRECT, INC DBA PHARMACARE SPECIALTY PHARMACY)
Contract Details
Approval Date
4/10/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Joseph Tate Curti, COO
(603) 663-2082
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/10/2025
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