340B Drug Pricing Program Database


RW424835E University of South Florida Health Pediatric Infectious Diseases (Active) - information as of 5/20/2025 12:47:43 AM

Main Details
University of South Florida Health Pediatric Infectious Diseases
USF Health Ybor Youth Clinic
Ryan White Part D
RW424835E
H12HA24835


Additional Details
Active
1/14/2025
4/1/2025
1/27/2025
8/1/2022 - 7/31/2026

Contacts

University of South Florida
Patricia Emmanuel, Chair, Department of Pediatrics
(813) 259-8866

University of South Florida
Kevin Astle, Clinical Pharmacist
(813) 974-4568

Addresses

1315 East 7th Avenue
Suite 104
Tampa, FL 33605

Same as Street Address


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
FL 1033606884,1881162402,1699784223,1013947654,1578573283,1093840522
Shipping Addresses

Same as Street Address
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailFLORIDA HLTH SCIENCES CTR INCTGH OUTPATIENT PHARMACY 5 TAMPA GENERAL CIR STE HMT -100
TAMPAFL33606-360101/27/202504/01/2025  04/01/2025
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsStateUpdate ApprovedActive4/1/2025 12:01 AM
ContactsSigned ByInsertNew Registration Emmanuel, Patricia Chair, Department of Pediatrics University of South Florida 81325988661/27/2025 10:06 AM
Details340B IDUpdateNew Registration RW424835E1/27/2025 10:06 AM
DatesParticipating Approval DateUpdateNew Registration 1/27/2025 10:06:01 AM1/27/2025 10:06 AM
DetailsStateUpdateNew RegistrationPendingApproved1/27/2025 10:06 AM
DatesSigned By DateUpdateNew Registration 1/15/2025 7:08:01 AM1/27/2025 10:06 AM
DatesStart DateUpdateNew Registration 4/1/2025 12:00:00 AM1/27/2025 10:06 AM
ContactsPrimary ContactUpdateProfile Change RequestAstle, Kevin Clinical Pharmacist University of South Florida 7274101824Astle, Kevin Clinical Pharmacist University of South Florida 81397445681/15/2025 12:18 PM
ContactsPrimary ContactUpdateProfile Change RequestAstle, Kevin Clinical Pharmacist University of South Florida Health 8139744568Astle, Kevin Clinical Pharmacist University of South Florida 72741018241/15/2025 7:01 AM
ContactsPrimary ContactUpdateProfile Change RequestAstle, Kevin Clinical Pharmacist University of South Florida Health 7274101824Astle, Kevin Clinical Pharmacist University of South Florida Health 81397445681/14/2025 2:56 PM
ContactsPrimary ContactUpdateProfile Change RequestAstle, Kevin Nicholas Clinical Pharmacist University of South Florida Health 7274101824Astle, Kevin Clinical Pharmacist University of South Florida Health 72741018241/14/2025 2:55 PM
AddressesMain AddressInsertNew Registration  1315 East 7th Avenue Suite 104 Tampa, FL 336051/14/2025 2:35 PM
Medicaid BillingNPI: NumberInsertNew Registration 10336068841/14/2025 2:35 PM
Medicaid BillingNPI: StateInsertNew Registration FL1/14/2025 2:35 PM
Medicaid BillingNPI: NumberInsertNew Registration 18811624021/14/2025 2:35 PM
Medicaid BillingNPI: StateInsertNew Registration FL1/14/2025 2:35 PM
Medicaid BillingNPI: NumberInsertNew Registration 16997842231/14/2025 2:35 PM
Medicaid BillingNPI: StateInsertNew Registration FL1/14/2025 2:35 PM
Medicaid BillingNPI: NumberInsertNew Registration 10139476541/14/2025 2:35 PM
Medicaid BillingNPI: StateInsertNew Registration FL1/14/2025 2:35 PM
Medicaid BillingNPI: NumberInsertNew Registration 15785732831/14/2025 2:35 PM
Medicaid BillingNPI: StateInsertNew Registration FL1/14/2025 2:35 PM
Medicaid BillingNPI: NumberInsertNew Registration 10938405221/14/2025 2:35 PM
Medicaid BillingNPI: StateInsertNew Registration FL1/14/2025 2:35 PM
ContactsPrimary ContactInsertNew Registration Astle, Kevin Nicholas Clinical Pharmacist University of South Florida Health 72741018241/14/2025 2:35 PM
ContactsAuthorizing OfficialInsertNew Registration Emmanuel, Patricia Chair, Department of Pediatrics University of South Florida 81325988661/14/2025 2:35 PM
DetailsAssistance Received From DateInsertNew Registration 8/1/2022 12:00:00 AM1/14/2025 2:35 PM
DetailsAssistance Received To DateInsertNew Registration 7/31/2026 12:00:00 AM1/14/2025 2:35 PM
DetailsLast Recertification DateInsertNew Registration  1/14/2025 2:35 PM
DetailsGrant NumberInsertNew Registration H12HA248351/14/2025 2:35 PM
Details340B IDInsertNew Registration  1/14/2025 2:35 PM
DetailsIs Authorizing Official EHB DataInsertNew Registration  1/14/2025 2:35 PM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  1/14/2025 2:35 PM
DetailsMedicare Provider NumberInsertNew Registration  1/14/2025 2:35 PM
DetailsEntity NameInsertNew Registration University of South Florida Health Pediatric Infectious Diseases1/14/2025 2:35 PM
DetailsNOFO NumberInsertNew Registration  1/14/2025 2:35 PM
DetailsProgram CodeInsertNew Registration RW41/14/2025 2:35 PM
DetailsEntity SubnameInsertNew Registration USF Health Ybor Youth Clinic1/14/2025 2:35 PM
DatesParticipating Approval DateInsertNew Registration  1/14/2025 2:35 PM
DetailsStateInsertNew Registration Pending1/14/2025 2:35 PM
DatesRegistration DateInsertNew Registration 1/14/2025 2:35:34 PM1/14/2025 2:35 PM
DatesSigned By DateInsertNew Registration  1/14/2025 2:35 PM
DatesStart DateInsertNew Registration  1/14/2025 2:35 PM
TerminationsTermination CommentsInsertNew Registration  1/14/2025 2:35 PM
TerminationsTermination DateInsertNew Registration  1/14/2025 2:35 PM
TerminationsTermination Effective DateInsertNew Registration  1/14/2025 2:35 PM
TerminationsTermination ReasonInsertNew Registration  1/14/2025 2:35 PM