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PROCARE PHARMACY DIRECT, L.L.C.
DSH260078 Ozarks Medical Center DBA Ozarks Healthcare
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Covered Entity Details
Entity Name
Ozarks Medical Center DBA Ozarks Healthcare
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH260078
Entity Address
1100 KENTUCKY AVENUE
WEST PLAINS, MO 65775-1100
Medicare Provider Number
260078
Participating Start Date
1/1/2005
Last Recertification Date
8/19/2024
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
4/21/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lacey Carter, Chief Operating Officer
(417) 256-9111 Ext: 5968
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/21/2025
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