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PROCARE PHARMACY DIRECT, L.L.C.
DSH210012 SINAI HOSPITAL OF BALTIMORE
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Covered Entity Details
Entity Name
SINAI HOSPITAL OF BALTIMORE
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH210012
Entity Address
2401 WEST BELVEDERE AVENUE
BALTIMORE, MD 21215
Medicare Provider Number
210012
Participating Start Date
7/1/2003
Last Recertification Date
8/15/2024
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
7/15/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
NEIL MELTZER, PRESIDENT/CEO
(410) 601-5134
Contract Pharmacy Representative
CVS/Caremark
Jason Kwasigroch, Sr. Advisor, Specialty CVS/caremark
(847) 559-5619
Signed By Date
7/15/2016
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