Covered Entity Details

STD336261 Harmony Healthcare Orlando, Inc (Active) - information as of 5/9/2025 10:42:50 PM

Main Details

Name

Harmony Healthcare Orlando, Inc

Subdivision Name

Harmony Healthcare, Inc

Type

Sexually Transmitted Diseases

340B ID

STD336261

Grant Number

NH25PS005131

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

In-Kind products or services (see note below; must have been purchased with section 318 funds)
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.
HIV tests and other supplies including condoms. Training and tech support as well as capacity building
3/1/2021

Additional Details

Current Program Status

Active

Registration Date

4/14/2021

Participating Start Date

7/1/2021

Participating Approval Date

5/5/2021

Last Recertification Date

5/7/2025

Notice of Funding Opportunity (NOFO) Number

PS18-1802

Contacts

Authorizing Official

Harmony Healthcare Orlando, Inc
Priscilla Torres-Theobald, Executive Director
(407) 777-2022 Ext: 102

Primary Contact

Harmony Healthcare Orlando, Inc
Paul Matthew Chan, Chief Clinical Officer
(407) 777-2022 Ext: 101

Addresses

Street Address

13047 W. Linebaugh Ave
Suite 101
Tampa, FL 33626

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?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	ANGEL'S PHARMACY I INC	259 E MICHIGAN ST		ORLANDO	FL	32806	05/05/2021	07/01/2021		07/01/2021
Contract Detail	ANGELS PHARMACY III LLC	7455 S US HIGHWAY 1 STE A		TITUSVILLE	FL	32780	07/15/2024	09/03/2024		09/03/2024
Contract Detail	AVITA DRUGS FLORIDA, LLC DBA AVITA PHARM	8601 COMMODITY CIR, SUITE 105		ORLANDO	FL	32819-9003	04/15/2025	07/01/2025		04/15/2025
Contract Detail	AVITA PHARMACY 1047	AVITA DRUGS FLORIDA LLC D/B/A AVITA PHAR	1110 KEVSTIN DR	KISSIMMEE	FL	34744	04/15/2024	07/01/2024		07/01/2024
Contract Detail	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	01/18/2022	04/01/2022		04/01/2022
Contract Detail	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	01/18/2022	04/01/2022		04/01/2022
Contract Detail	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	01/18/2022	04/01/2022		04/01/2022
Contract Detail	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	01/18/2022	04/01/2022		04/01/2022
Contract Detail	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	01/18/2022	04/01/2022		04/01/2022
Contract Detail	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	01/18/2022	04/01/2022		04/01/2022
Contract Detail	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	01/18/2022	04/01/2022		04/01/2022
Contract Detail	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	01/18/2022	04/01/2022		04/01/2022
Contract Detail	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	01/18/2022	04/01/2022		04/01/2022
Contract Detail	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	01/18/2022	04/01/2022		04/01/2022
Contract Detail	COMMUNITY, A WALGREENS PHARMACY	2100 B NORTH ORANGE AVE		ORLANDO	FL	32804	04/15/2022	07/01/2022	12/21/2022	12/21/2022
Contract Detail	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	01/18/2022	04/01/2022		04/01/2022
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 02759	845 4TH ST. NORTH	SAINT PETERSBURG	FL	33701	01/18/2022	04/01/2022		04/01/2022
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 02873	2200 34TH STREET NORTH	SAINT PETERSBURG	FL	33713	01/18/2022	04/01/2022		04/01/2022
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05196	11670 COUNTRYWAY BLVD	TAMPA	FL	33626	01/18/2022	04/01/2022	05/25/2023	05/25/2023
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05253	8801 W LINEBAUGH AVE	TAMPA	FL	33626	01/18/2022	04/01/2022		04/01/2022
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05783	8603 WEST HILLSBOROUGH AVE	TAMPA	FL	33615	01/18/2022	04/01/2022		04/01/2022
Contract Detail	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	04/15/2024	07/01/2024		07/01/2024
Contract Detail	NORTH TAMPA PHARMACY, INC,	BAY AREA PHARMACY	1721 W FLETCHER AVE	TAMPA	FL	33612	05/05/2021	07/01/2021	01/04/2024	01/04/2024
Contract Detail	PRIME THERAPEUTICS SPECIALTY PHARMACY LL	ALLIANCERX WALGREENS PRIME #16568	2354 COMMERCE PARK DRIVE SUITE 100	ORLANDO	FL	32819-9992	04/15/2022	07/01/2022	06/06/2022	06/06/2022
Contract Detail	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	01/18/2022	04/01/2022		04/01/2022
Contract Detail	PROCARE PHARMACY, L.L.C.	NAVARRO SPECIALTY SERVICES # 10727	7205 CORPORATE CENTER DRIVE SUITE 104	MIAMI	FL	33126	01/18/2022	04/01/2022		04/01/2022
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	01/18/2022	04/01/2022		04/01/2022
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	01/18/2022	04/01/2022	01/18/2022	01/18/2022
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	01/18/2022	04/01/2022		04/01/2022
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	01/18/2022	04/01/2022		04/01/2022
Contract Detail	WALGREEN CO	DBA: WALGREENS #10398	13911 NINE EAGLES DR	TAMPA	FL	33626	04/15/2022	07/01/2022		07/01/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 02975	15602 N. DALE MABRY	TAMPA	FL	33618	04/15/2022	07/01/2022		07/01/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06192	6503 W WATERS AVE	TAMPA	FL	33634-2207	04/15/2022	07/01/2022		07/01/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 13824	18511 N. US HWY 41	LUTZ	FL	33549	04/15/2022	07/01/2022		07/01/2022
Contract Detail	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #21226	1506 W KENNEDY BLVD STE A	TAMPA	FL	33606	04/15/2022	07/01/2022		07/01/2022
Contract Detail	Walgreens #21395	Walgreens Central Fill #21395	5710 Young Pine Rd	Orlando	FL	32829	10/14/2022	01/01/2023		01/01/2023

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	5/31/2024 3:23:46 PM	5/7/2025 10:05:10 AM	5/7/2025 10:05 AM
Addresses	Main Address	Update	Change Request	13047 W. Linebaugh Ave Randolph Diabetes and Wellness Suite 101 Tampa, FL 33626	13047 W. Linebaugh Ave Suite 101 Tampa, FL 33626	4/15/2025 3:28 PM
Contacts	Primary Contact	Update	Change Request	Randolph, Kimberly Community Manager Randolph Wellness & Diabetes Center 8134756542	Chan, Paul Matthew Chief Clinical Officer Harmony Healthcare Orlando, Inc 4077772022-101	4/15/2025 3:28 PM
Contacts	Authorizing Official	Update	AO Change Request	Torres, Priscilla Executive Director Harmony Healthcare Orlando, Inc 4077772022	Torres-Theobald, Priscilla Executive Director Harmony Healthcare Orlando, Inc 4077772022-102	11/21/2024 6:32 AM
Details	Last Recertification Date	Update	Recertification	6/1/2023 2:58:23 PM	5/31/2024 3:23:46 PM	5/31/2024 3:23 PM
Addresses	Main Address	Update	Change Request	13047 W. Linebaugh Ave Randolph Diabetes and Wellness Tampa, FL 33626	13047 W. Linebaugh Ave Randolph Diabetes and Wellness Suite 101 Tampa, FL 33626	3/19/2024 2:35 PM
Details	Nature of Support: Support Received To Date	Update	Change Request	2/29/2024 12:00:00 AM		3/19/2024 2:35 PM
Details	Entity Subname	Update	Change Request		Harmony Healthcare, Inc	3/19/2024 2:35 PM
Details	Last Recertification Date	Update	Recertification	6/6/2022 9:54:13 AM	6/1/2023 2:58:23 PM	6/1/2023 2:58 PM
Details	Last Recertification Date	Update	Recertification		6/6/2022 9:54:13 AM	6/6/2022 9:54 AM
Details	State	Update		Approved	Active	7/1/2021 12:01 AM
Contacts	Signed By	Insert	New Registration		Torres, Priscilla Executive Director Harmony Healthcare Orlando, Inc 4077772022	5/5/2021 12:30 PM
Details	340B ID	Update	New Registration		STD336261	5/5/2021 12:30 PM
Dates	Participating Approval Date	Update	New Registration		5/5/2021 12:30:51 PM	5/5/2021 12:30 PM
Details	State	Update	New Registration	Pending	Approved	5/5/2021 12:30 PM
Dates	Signed By Date	Update	New Registration		4/14/2021 8:28:09 PM	5/5/2021 12:30 PM
Dates	Start Date	Update	New Registration		7/1/2021 12:00:00 AM	5/5/2021 12:30 PM
Addresses	Main Address	Insert	New Registration		13047 W. Linebaugh Ave Randolph Diabetes and Wellness Tampa, FL 33626	4/14/2021 8:28 PM
Details	Nature of Support: In Kind Support Description	Insert	New Registration		HIV tests and other supplies including condoms. Training and tech support as well as capacity building	4/14/2021 8:28 PM
Details	Nature Of Support	Insert	New Registration		In-Kind products or services (see note below; must have been purchased with section 318 funds)	4/14/2021 8:28 PM
Details	Nature of Support: Support Received From Date	Insert	New Registration		3/1/2021 12:00:00 AM	4/14/2021 8:28 PM
Details	Nature of Support: Support Received To Date	Insert	New Registration		2/29/2024 12:00:00 AM	4/14/2021 8:28 PM
Contacts	Authorizing Official	Insert	New Registration		Torres, Priscilla Executive Director Harmony Healthcare Orlando, Inc 4077772022	4/14/2021 8:28 PM
Contacts	Primary Contact	Insert	New Registration		Randolph, Kimberly Community Manager Randolph Wellness & Diabetes Center 8134756542	4/14/2021 8:28 PM
Details	Assistance Received From Date	Insert	New Registration			4/14/2021 8:28 PM
Details	Assistance Received To Date	Insert	New Registration			4/14/2021 8:28 PM
Details	Last Recertification Date	Insert	New Registration			4/14/2021 8:28 PM
Details	Grant Number	Insert	New Registration		NH25PS005131	4/14/2021 8:28 PM
Details	340B ID	Insert	New Registration			4/14/2021 8:28 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/14/2021 8:28 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/14/2021 8:28 PM
Details	Medicare Provider Number	Insert	New Registration			4/14/2021 8:28 PM
Details	Entity Name	Insert	New Registration		Harmony Healthcare Orlando, Inc	4/14/2021 8:28 PM
Details	NOFO Number	Insert	New Registration		PS18-1802	4/14/2021 8:28 PM
Details	Program Code	Insert	New Registration		STD	4/14/2021 8:28 PM
Details	Entity Subname	Insert	New Registration			4/14/2021 8:28 PM
Dates	Participating Approval Date	Insert	New Registration			4/14/2021 8:28 PM
Details	State	Insert	New Registration		Pending	4/14/2021 8:28 PM
Dates	Registration Date	Insert	New Registration		4/14/2021 8:28:07 PM	4/14/2021 8:28 PM
Dates	Signed By Date	Insert	New Registration			4/14/2021 8:28 PM
Dates	Start Date	Insert	New Registration			4/14/2021 8:28 PM
Terminations	Termination Comments	Insert	New Registration			4/14/2021 8:28 PM
Terminations	Termination Date	Insert	New Registration			4/14/2021 8:28 PM
Terminations	Termination Effective Date	Insert	New Registration			4/14/2021 8:28 PM
Terminations	Termination Reason	Insert	New Registration			4/14/2021 8:28 PM

340B Drug Pricing Program Database

Comments

Medicaid Billing

Shipping Addresses

Contract Pharmacies

History