Covered Entity Details

STD33712 Empath Health, Inc. (Active) - information as of 4/29/2025 11:56:49 PM

Main Details

Name

Empath Health, Inc.

Subdivision Name

AIDS Service Association of Pinellas dba EPIC

Type

Sexually Transmitted Diseases

340B ID

STD33712

Grant Number

1NU62PS924687-1-00

Nature of Support
Please Describe the “in-kind” Support
Time period section 318 funding or in-kind support was received

Direct Funding (dollars received from CDC or an intermediate organization)
Note: In-kind contributions may be in the form of real property, equipment, supplies and other expendable property, and goods and services directly benefiting and specifically identifiable to the project or program.

7/1/2021 - 6/30/2026

Additional Details

Current Program Status

Active

Registration Date

1/10/2018

Participating Start Date

4/1/2018

Participating Approval Date

2/5/2018

Last Recertification Date

5/9/2024

Notice of Funding Opportunity (NOFO) Number

CDC PS21-2102

Contacts

Authorizing Official

Empath Health
Saida Bouhamid, Chief Mission Financial Officer
(727) 523-3339

Primary Contact

AIDS Service Association of Pinellas, Inc dba EPIC
Joy Winheim, Executive Director
(727) 328-5525

Addresses

Street Address

3050 1st Ave S
St. Petersburg, FL 33712

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
FL		1407257470,1669856357,1790194975

Shipping Addresses

Shipping Address 1

Empath Health Pharmaceuticals, LLC
4703 N. Florida Ave.
Tampa, FL 33603

Shipping Address 2

Empath Health Pharmaceuticals, LLC
11701 S. Belcher Rd.
Suite 126
Largo, FL 33773

Shipping Address 3

Empath Health Pharmaceuticals, LLC
3050 1st Avenue S.
St. Petersburg, FL 33712

Shipping Address 4

Empath Health Pharmaceuticals, LLC
5771 Roosevelt Blvd.
Suite 466
Clearwater, FL 33760

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	04/02/2018	07/01/2018	04/21/2021	04/22/2021
Contract Detail	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	10/31/2023	01/01/2024		01/01/2024
Contract Detail	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	10/31/2023	01/01/2024		01/01/2024
Contract Detail	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	10/31/2023	01/01/2024		01/01/2024
Contract Detail	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	10/31/2023	01/01/2024		01/01/2024
Contract Detail	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	10/31/2023	01/01/2024		01/01/2024
Contract Detail	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	10/31/2023	01/01/2024		01/01/2024
Contract Detail	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	10/31/2023	01/01/2024		01/01/2024
Contract Detail	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	10/31/2023	01/01/2024		01/01/2024
Contract Detail	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	10/31/2023	01/01/2024		01/01/2024
Contract Detail	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	10/31/2023	01/01/2024		01/01/2024
Contract Detail	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	10/31/2023	01/01/2024		01/01/2024
Contract Detail	EMPATH HEALTH PHARMACEUTICALS, LLC	EMPATH HEALTH PHARMACY	PHARMACY DEPARTMENT 3050 1ST AVE S	ST PETERSBURG	FL	33712	04/02/2018	07/01/2018	10/21/2020	10/22/2020
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03615	1899 N HIGHLAND AVE	CLEARWATER	FL	33755	07/07/2023	10/01/2023	12/02/2024	02/10/2025
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 02731	2200 GULF TO BAY BLVD.	CLEARWATER	FL	33765	07/07/2023	10/01/2023		10/01/2023
Contract Detail	HOLIDAY CVS, L.L.C.	CVS PHARMACY # 16941	2747 GULF TO BAY BLVD	CLEARWATER	FL	33759	07/07/2023	10/01/2023		10/01/2023
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03804	2528 N MCMULLEN BOOTH RD	CLEARWATER	FL	33761	07/07/2023	10/01/2023		10/01/2023
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03686	30387 US HWY 19 N	CLEARWATER	FL	33761	07/07/2023	10/01/2023		10/01/2023
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 02874	4000 EAST BAY DRIVE	CLEARWATER	FL	33764	07/07/2023	10/01/2023		10/01/2023
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03001	467 MANDALAY AVE	CLEARWATER BEACH	FL	33767	07/07/2023	10/01/2023		10/01/2023
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03960	3765 ULMERTON RD	CLEARWATER	FL	33762	07/07/2023	10/01/2023		10/01/2023
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 00104	1 S MISSOURI AVE	CLEARWATER	FL	33756	07/07/2023	10/01/2023		10/01/2023
Contract Detail	HOSPICE OF THE FLORIDA	EMPATH HEALTH PHARMACY	11701 S BELCHER RD UNIT 126	LARGO	FL	33773	04/06/2018	07/01/2018	10/21/2020	10/22/2020
Contract Detail	NPS PHARMACY DIRECT	442 METROPLEX DR	STE 401	NASHVILLE	TN	37211	04/18/2024	07/01/2024		07/01/2024
Contract Detail	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	10/31/2023	01/01/2024		01/01/2024
Contract Detail	PROCARE PHARMACY, L.L.C.	NAVARRO SPECIALTY SERVICES # 10727	7205 CORPORATE CENTER DRIVE SUITE 104	MIAMI	FL	33126	07/07/2023	10/01/2023		10/01/2023
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	10/31/2023	01/01/2024		01/01/2024
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY OR CARELONRX SPECIALTY	ONE WATERFRONT PLAZA 500 ALA MOANA BLVD., BLDG 1	HONOLULU	HI	96813	10/31/2023	01/01/2024		01/01/2024
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	10/31/2023	01/01/2024		01/01/2024
Contract Detail	PUBLIX SUPER MARKETS	PUBLIX PHARMACY #0129	1220 KINGSWAY RD	BRANDON	FL	33510	07/22/2024	10/01/2024	10/01/2024	10/03/2024
Contract Detail	PUBLIX SUPER MARKETS	PUBLIX PHARMACY #1410	6767 US HIGHWAY 98 NORTH	LAKELAND	FL	33809-6226	07/22/2024	10/01/2024		10/01/2024
Contract Detail	PUBLIX SUPER MARKETS, INC.	PUBLIX PHARMACY #3219	300 PINELLAS ST.	CLEARWATER	FL	33756	07/22/2024	10/01/2024		10/01/2024
Contract Detail	PUBLIX SUPER MARKETS, INC.	PUBLIX PHARMACY 0611	1313 S DALE MABRY HWY	TAMPA	FL	33629-5010	07/22/2024	10/01/2024		10/01/2024
Contract Detail	PUBLIX SUPER MARKETS, INC.	PUBLIX PHARMACY #0095	10801 STARKEY RD STE 200	SEMINOLE	FL	33777-1161	07/22/2024	10/01/2024	10/01/2024	10/03/2024
Contract Detail	PUBLIX SUPER MARKETS, INC.	PUBLIX CENTRAL PHARMACY #3201	2424 ORLANDO CENTRAL PARKWAY	ORLANDO	FL	32809	07/22/2024	10/01/2024		10/01/2024
Contract Detail	PUBLIX SUPER MARKETS, INC.	PUBLIX PHARMACY #3213	1950 SAND LAKE RD, BLDG #5	ORLANDO	FL	32809	07/22/2024	10/01/2024		10/01/2024
Contract Detail	PUBLIX SUPER MARKETS, INC.	PUBLIX PHARMACY #1371	3863 SOUTH US HIGHWAY 301	RIVERVIEW	FL	33578	07/22/2024	10/01/2024	10/01/2024	10/03/2024
Contract Detail	PUBLIX SUPER MARKETS, INC.	PUBLIX PHARMACY #1320	7880 113TH STREET	SEMINOLE	FL	33772	07/22/2024	10/01/2024	10/01/2024	10/03/2024
Contract Detail	URBAN SPECIALTY PHARMACY, LLC	1617 34TH ST S STE A		ST PETERSBURG	FL	33711-2855	10/16/2018	01/01/2019		01/01/2019
Contract Detail	WELLGISTICS PHARMACY LLC	WELLGISTICS HUB	6308 BENJAMIN RD STE 709	TAMPA	FL	33634	10/16/2018	01/01/2019	12/10/2018	12/19/2018
Contract Detail	WELLGISTICS PHARMACY LLC	WELLGISTICS HUB	6308 BENJAMIN RD STE 709	TAMPA	FL	33634	01/21/2019	04/01/2019		04/01/2019

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	5/25/2023 10:31:10 AM	5/9/2024 11:19:09 AM	5/9/2024 11:19 AM
Details	Nature of Support: In Kind Support Description	Insert	Recertification			5/25/2023 10:31 AM
Details	Nature Of Support	Insert	Recertification		Direct Funding (dollars received from CDC or an intermediate organization)	5/25/2023 10:31 AM
Details	Nature of Support: Support Received From Date	Insert	Recertification		7/1/2021 12:00:00 AM	5/25/2023 10:31 AM
Details	Nature of Support: Support Received To Date	Insert	Recertification		6/30/2026 12:00:00 AM	5/25/2023 10:31 AM
Details	Nature Of Support	Delete	Recertification	In-Kind products or services (see note below; must have been purchased with section 318 funds) (01/03/2022)-(12/30/2022) HIV testing supplies, condoms		5/25/2023 10:31 AM
Details	Last Recertification Date	Update	Recertification	5/11/2022 2:27:45 PM	5/25/2023 10:31:10 AM	5/25/2023 10:31 AM
Details	Grant Number	Update	Recertification	NH25PS005131	1NU62PS924687-1-00	5/25/2023 10:31 AM
Details	NOFO Number	Update	Recertification	PS19-1901	CDC PS21-2102	5/25/2023 10:31 AM
Details	Entity Subname	Update	Recertification	AIDS Service Association of Pinellas	AIDS Service Association of Pinellas dba EPIC	5/25/2023 10:31 AM
Details	Nature of Support: Support Received From Date	Update	Recertification	1/1/2021 12:00:00 AM	1/3/2022 12:00:00 AM	5/11/2022 2:27 PM
Details	Nature of Support: Support Received To Date	Update	Recertification	12/31/2021 12:00:00 AM	12/30/2022 12:00:00 AM	5/11/2022 2:27 PM
Details	Last Recertification Date	Update	Recertification	5/19/2021 8:51:12 AM	5/11/2022 2:27:45 PM	5/11/2022 2:27 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1407257470	4/16/2022 9:44 AM
Medicaid Billing	NPI: State	Insert	Change Request		FL	4/16/2022 9:44 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1669856357	4/16/2022 9:44 AM
Medicaid Billing	NPI: State	Insert	Change Request		FL	4/16/2022 9:44 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1790194975	4/16/2022 9:44 AM
Medicaid Billing	NPI: State	Insert	Change Request		FL	4/16/2022 9:44 AM
Addresses	Shipping Address	Delete	Change Request	Empath Health Pharmaceuticals, LLC 5771 Roosevelt Blvd. Clearwater, FL 33760		6/15/2021 5:48 PM
Addresses	Shipping Address	Insert	Change Request		Empath Health Pharmaceuticals, LLC 5771 Roosevelt Blvd. Suite 466 Clearwater, FL 33760	6/15/2021 5:48 PM
Contacts	Authorizing Official	Update	Change Request	Morel, Mitchel CFO Empath Health 7275233339	Bouhamid, Saida Chief Mission Financial Officer Empath Health 7275233339	6/15/2021 5:48 PM
Details	Nature of Support: In Kind Support Description	Update	Recertification		HIV testing supplies, condoms	5/19/2021 8:51 AM
Details	Nature of Support: Support Received From Date	Update	Recertification		1/1/2021 12:00:00 AM	5/19/2021 8:51 AM
Details	Nature of Support: Support Received To Date	Update	Recertification		12/31/2021 12:00:00 AM	5/19/2021 8:51 AM
Details	Last Recertification Date	Update	Recertification	5/20/2020 8:07:38 AM	5/19/2021 8:51:12 AM	5/19/2021 8:51 AM
Details	Grant Number	Update	Recertification	NH25PS004342	NH25PS005131	5/19/2021 8:51 AM
Details	Entity Name	Update	Recertification	Empath Health	Empath Health, Inc.	5/19/2021 8:51 AM
Details	NOFO Number	Update	Recertification		PS19-1901	5/19/2021 8:51 AM
Addresses	Shipping Address	Insert	Change Request		Empath Health Pharmaceuticals, LLC 4703 N. Florida Ave. Tampa, FL 33603	10/1/2020 9:24 AM
Addresses	Shipping Address	Insert	Change Request		Empath Health Pharmaceuticals, LLC 5771 Roosevelt Blvd. Clearwater, FL 33760	10/1/2020 9:24 AM
Addresses	Shipping Address	Insert	Change Request		Empath Health Pharmaceuticals, LLC 11701 S. Belcher Rd. Suite 126 Largo, FL 33773	10/1/2020 9:24 AM
Addresses	Shipping Address	Insert	Change Request		Empath Health Pharmaceuticals, LLC 3050 1st Avenue S. St. Petersburg, FL 33712	10/1/2020 9:24 AM
Details	Last Recertification Date	Update	Recertification	5/23/2019 9:51:50 AM	5/20/2020 8:07:38 AM	5/20/2020 8:07 AM
Details	Last Recertification Date	Update	Recertification	5/3/2018 9:59:42 AM	5/23/2019 9:51:50 AM	5/23/2019 9:51 AM
Details	Last Recertification Date	Update	Recertification		5/3/2018 9:59:42 AM	5/3/2018 9:59 AM
Details	State	Update		Approved	Active	4/1/2018 12:00 AM
Addresses	Main Address	Insert	New Registration		3050 1st Ave S St. Petersburg, FL 33712	2/5/2018 3:23 PM
Contacts	Signed By	Insert	New Registration		Morel, Mitchel CFO Empath Health 7275233339	2/5/2018 3:23 PM
Details	Grant Number	Update	New Registration	PSB85	NH25PS004342	2/5/2018 3:23 PM
Details	340B ID	Update	New Registration		STD33712	2/5/2018 3:23 PM
Dates	Participating Approval Date	Update	New Registration		2/5/2018 3:23:08 PM	2/5/2018 3:23 PM
Details	State	Update	New Registration	Pending	Approved	2/5/2018 3:23 PM
Dates	Signed By Date	Update	New Registration		2/5/2018 1:08:01 PM	2/5/2018 3:23 PM
Dates	Start Date	Update	New Registration		4/1/2018 12:00:00 AM	2/5/2018 3:23 PM
Addresses	Main Address	Insert	New Registration		3050 1st Ave S St. Petersburg, FL 33712	1/10/2018 1:27 PM
Details	Nature Of Support	Insert	New Registration		In-Kind products or services (see note below; must have been purchased with section 318 funds)	1/10/2018 1:27 PM
Contacts	Primary Contact	Insert	New Registration		Winheim, Joy Executive Director AIDS Service Association of Pinellas, Inc dba EPIC 7273285525	1/10/2018 1:27 PM
Contacts	Authorizing Official	Insert	New Registration		Morel, Mitchel CFO Empath Health 7275233339	1/10/2018 1:27 PM
Details	Last Recertification Date	Insert	New Registration			1/10/2018 1:27 PM
Details	Grant Number	Insert	New Registration		PSB85	1/10/2018 1:27 PM
Details	340B ID	Insert	New Registration			1/10/2018 1:27 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/10/2018 1:27 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/10/2018 1:27 PM
Details	Medicare Provider Number	Insert	New Registration			1/10/2018 1:27 PM
Details	Entity Name	Insert	New Registration		Empath Health	1/10/2018 1:27 PM
Details	Program Code	Insert	New Registration		STD	1/10/2018 1:27 PM
Details	Entity Subname	Insert	New Registration		AIDS Service Association of Pinellas	1/10/2018 1:27 PM
Dates	Participating Approval Date	Insert	New Registration			1/10/2018 1:27 PM
Details	State	Insert	New Registration		Pending	1/10/2018 1:27 PM
Dates	Registration Date	Insert	New Registration		1/10/2018 1:27:42 PM	1/10/2018 1:27 PM
Dates	Signed By Date	Insert	New Registration			1/10/2018 1:27 PM
Dates	Start Date	Insert	New Registration			1/10/2018 1:27 PM
Terminations	Termination Comments	Insert	New Registration			1/10/2018 1:27 PM
Terminations	Termination Date	Insert	New Registration			1/10/2018 1:27 PM
Terminations	Termination Effective Date	Insert	New Registration			1/10/2018 1:27 PM
Terminations	Termination Reason	Insert	New Registration			1/10/2018 1:27 PM

340B Drug Pricing Program Database

Comments

Medicaid Billing

Shipping Addresses

Contract Pharmacies

History