| Details | Assistance Received To Date | Update | Recertification | 2/28/2025 12:00:00 AM | 2/28/2026 12:00:00 AM | 3/10/2025 3:12 PM |
| Details | Last Recertification Date | Update | Recertification | 2/16/2024 7:29:49 AM | 3/10/2025 3:12:53 PM | 3/10/2025 3:12 PM |
| Addresses | Shipping Address | Update | Change Request | CAN Community Health Pharmacy of Ft. Lauderdale
4101 NW 3rd Court
Ste 9
Plantation, FL 33317 | CAN Community Health Pharmacy of Ft. Lauderdale
4101 NW 3rd Court
Medical Plaza
Ste 9
Plantation, FL 33317 | 1/29/2025 2:06 PM |
| Contacts | Authorizing Official | Update | Profile Change Request | Patel, Rishi
President & CEO
CAN Community Health, Inc.
9413660461-11127 | Patel, Rishi
President & CEO
CAN Community Health, Inc.
9413004440-11127 | 1/28/2025 7:30 PM |
| Addresses | Billing Address | Update | Group Change Request | CAN Community Health, Inc.
4440 Fruitville Rd
SARASOTA, FL 34232 | CAN Community Health, Inc.
2105 N. Nebraska Ave.
Tampa, FL 33602 | 6/20/2024 3:06 PM |
| Details | Last Recertification Date | Update | Recertification | 2/26/2023 3:30:26 PM | 2/16/2024 7:29:49 AM | 2/16/2024 7:29 AM |
| Details | NOFO Number | Update | | HRSA-21-055 | | 12/16/2023 10:34 AM |
| Addresses | Shipping Address | Update | Change Request | Tampa Family Pharmacy
2919 W Swann Ave.
Ste 101
Tampa, FL 33609 | Tampa Family Pharmacy
12470 Telecom Dr
Ste 110W
Temple Terrace, FL 33637 | 12/11/2023 1:01 PM |
| Details | Assistance Received To Date | Update | Recertification | 2/28/2023 12:00:00 AM | 2/28/2025 12:00:00 AM | 2/26/2023 3:30 PM |
| Details | Last Recertification Date | Update | Recertification | 2/25/2022 3:59:28 PM | 2/26/2023 3:30:26 PM | 2/26/2023 3:30 PM |
| Addresses | Shipping Address | Insert | Change Request | | JTJ Medical Supply Inc., d/b/a Mail-Meds Clinical Pharmacy
2692 Oak Ridge Ct
Fort Myers, FL 33901 | 7/19/2022 9:39 AM |
| Addresses | Shipping Address | Insert | Change Request | | Tampa Family Pharmacy
2919 W Swann Ave.
Ste 101
Tampa, FL 33609 | 7/19/2022 9:39 AM |
| Details | Assistance Received To Date | Update | Change Request | 2/28/2022 12:00:00 AM | 2/28/2023 12:00:00 AM | 7/19/2022 9:39 AM |
| Contacts | Authorizing Official | Update | Profile Change Request | Patel, Rishi
Interim President & CEO
CAN Community Health, Inc.
9413660461-11127 | Patel, Rishi
President & CEO
CAN Community Health, Inc.
9413660461-11127 | 7/5/2022 4:02 PM |
| Contacts | Primary Contact | Update | Profile Change Request | Joshi, Hemali
VP Enterprise Systems & Pharmacy Analytics
CAN Community Health, Inc.
9413004440-10161 | Joshi, Hemali
SVP, Chief Data Officer
CAN Community Health, Inc.
9413004440-10161 | 4/8/2022 1:34 PM |
| Details | Last Recertification Date | Update | Recertification | 3/1/2021 10:32:34 AM | 2/25/2022 3:59:28 PM | 2/25/2022 3:59 PM |
| Addresses | Shipping Address | Insert | Change Request | | CAN Community Health Pharmacy of Arlington
603 Matlock Centre Cir
Arlington, TX 76015 | 10/7/2021 10:59 AM |
| Contacts | Primary Contact | Update | Profile Change Request | Joshi, Hemali
VP Quality, Analytics & Pharmacy Operations
CAN Community Health, Inc.
9413004440-10161 | Joshi, Hemali
VP Enterprise Systems & Pharmacy Analytics
CAN Community Health, Inc.
9413004440-10161 | 10/6/2021 12:58 PM |
| Contacts | Authorizing Official | Update | Change Request | Carlisle, Richard E.
President & CEO
CAN Community Health, Inc.
9413660134-11111 | Patel, Rishi
Interim President & CEO
CAN Community Health, Inc.
9413660461-11127 | 6/23/2021 12:52 PM |
| Contacts | Primary Contact | Update | Change Request | Patel, Rishi
Interim President & CEO
CAN Community Health, Inc.
9413660461-11127 | Joshi, Hemali
VP Quality, Analytics & Pharmacy Operations
CAN Community Health, Inc.
9413004440-10161 | 6/23/2021 12:52 PM |
| Contacts | Primary Contact | Update | Profile Change Request | Patel, Rishi
Executive Vice President & Chief Operating Officer
CAN Community Health, Inc.
9413660461-11127 | Patel, Rishi
Interim President & CEO
CAN Community Health, Inc.
9413660461-11127 | 6/21/2021 12:48 PM |
| Details | Assistance Received From Date | Update | Recertification | | 3/1/2021 12:00:00 AM | 3/1/2021 10:32 AM |
| Details | Assistance Received To Date | Update | Recertification | | 2/28/2022 12:00:00 AM | 3/1/2021 10:32 AM |
| Details | Last Recertification Date | Update | Recertification | | 3/1/2021 10:32:34 AM | 3/1/2021 10:32 AM |
| Details | NOFO Number | Update | Recertification | | HRSA-21-055 | 3/1/2021 10:32 AM |
| Contacts | Primary Contact | Update | Profile Change Request | Patel, Rishi
Senior Vice President of Pharmacy Services
CAN Community Health, Inc.
9413660461-11127 | Patel, Rishi
Executive Vice President & Chief Operating Officer
CAN Community Health, Inc.
9413660461-11127 | 10/1/2020 3:09 PM |
| Addresses | Shipping Address | Insert | Change Request | | CAN Community Health Pharmacy of Clearwater
2349 Sunset Point Road
Ste 404
Clearwater, FL 33765 | 9/23/2020 7:55 PM |
| Addresses | Shipping Address | Insert | Change Request | | CAN Community Health Pharmacy of Jacksonville
4615 Philips Hwy
Ste 3
Jacksonville, FL 32207 | 9/23/2020 7:55 PM |
| Addresses | Shipping Address | Insert | Change Request | | CAN Community Health Pharmacy of Ft. Lauderdale
4101 NW 3rd Court
Ste 9
Plantation, FL 33317 | 9/23/2020 7:55 PM |
| Addresses | Main Address | Update | Change Request |
13936 NW 7th Ave
Miami, FL 33168 |
18360 NW 47th Ave
Miami Gardens, FL 33055 | 8/7/2020 2:56 PM |
| Details | State | Update | | Approved | Active | 7/1/2020 12:00 AM |
| Contacts | Signed By | Insert | New Registration | | Carlisle, Richard E.
President & CEO
CAN Community Health, Inc.
9413660134-11111 | 6/9/2020 7:08 AM |
| Details | 340B ID | Update | New Registration | | RWI33316C | 6/9/2020 7:08 AM |
| Dates | Participating Approval Date | Update | New Registration | | 6/9/2020 7:08:24 AM | 6/9/2020 7:08 AM |
| Details | State | Update | New Registration | Pending | Approved | 6/9/2020 7:08 AM |
| Dates | Signed By Date | Update | New Registration | | 6/8/2020 2:34:50 PM | 6/9/2020 7:08 AM |
| Dates | Start Date | Update | New Registration | | 7/1/2020 12:00:00 AM | 6/9/2020 7:08 AM |
| Addresses | Main Address | Insert | New Registration | |
13936 NW 7th Ave
Miami, FL 33168 | 5/28/2020 9:22 PM |
| Addresses | Billing Address | Insert | New Registration | | CAN Community Health, Inc.
4440 Fruitville Rd
SARASOTA, FL 34232 | 5/28/2020 9:22 PM |
| Contacts | Primary Contact | Insert | New Registration | | Patel, Rishi
Senior Vice President of Pharmacy Services
CAN Community Health, Inc.
9413660461-11127 | 5/28/2020 9:22 PM |
| Contacts | Authorizing Official | Insert | New Registration | | Carlisle, Richard E.
President & CEO
CAN Community Health, Inc.
9413660134-11111 | 5/28/2020 9:22 PM |
| Details | Last Recertification Date | Insert | New Registration | | | 5/28/2020 9:22 PM |
| Details | Grant Number | Insert | New Registration | | H89HA00005 | 5/28/2020 9:22 PM |
| Details | 340B ID | Insert | New Registration | | | 5/28/2020 9:22 PM |
| Details | Is Authorizing Official EHB Data | Insert | New Registration | | | 5/28/2020 9:22 PM |
| Dates | Last Date That 340B Drugs Purchased | Insert | New Registration | | | 5/28/2020 9:22 PM |
| Details | Medicare Provider Number | Insert | New Registration | | | 5/28/2020 9:22 PM |
| Details | Entity Name | Insert | New Registration | | CAN Community Health, Inc. | 5/28/2020 9:22 PM |
| Details | Program Code | Insert | New Registration | | RWI | 5/28/2020 9:22 PM |
| Details | Entity Subname | Insert | New Registration | | North Miami | 5/28/2020 9:22 PM |
| Dates | Participating Approval Date | Insert | New Registration | | | 5/28/2020 9:22 PM |
| Details | State | Insert | New Registration | | Pending | 5/28/2020 9:22 PM |
| Dates | Registration Date | Insert | New Registration | | 5/28/2020 9:22:26 PM | 5/28/2020 9:22 PM |
| Dates | Signed By Date | Insert | New Registration | | | 5/28/2020 9:22 PM |
| Dates | Start Date | Insert | New Registration | | | 5/28/2020 9:22 PM |
| Terminations | Termination Comments | Insert | New Registration | | | 5/28/2020 9:22 PM |
| Terminations | Termination Date | Insert | New Registration | | | 5/28/2020 9:22 PM |
| Terminations | Termination Effective Date | Insert | New Registration | | | 5/28/2020 9:22 PM |
| Terminations | Termination Reason | Insert | New Registration | | | 5/28/2020 9:22 PM |