Covered Entity Details

STD335441 West Central Gastroenterology dba Gastro Florida (Active) - information as of 4/25/2025 5:39:37 PM

Main Details

Name

West Central Gastroenterology dba Gastro Florida

Subdivision Name

Gastro Florida Division 19

Type

Sexually Transmitted Diseases

340B ID

STD335441

Grant Number

H25PS005131

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 Test Kits, Condoms, Patient Educational Materials
8/11/2020

Additional Details

Current Program Status

Active

Registration Date

7/14/2022

Participating Start Date

10/1/2022

Participating Approval Date

8/12/2022

Last Recertification Date

5/23/2024

Notice of Funding Opportunity (NOFO) Number

PS19-1901

Contacts

Authorizing Official

West Central Gastroenterology dba Gastro Florida
Seena Salyani, CEO
(727) 347-0536

Primary Contact

West Central Gastroenterology d.b.a. Gastro Florida
Jordan Kutner, Director of Operations
(727) 497-9152

Addresses

Street Address

3821 Maryweather Ln
Unit 101
Wesley Chapel, FL 33544

Billing Address

West Central Gastroenterology dba Gastro Florida
3001 Executive Dr. Ste 130
Clearwater, FL 33762

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

Shipping Address 1

West Central Gastroenterology dba Gastro Florida
3001 Executive Dr. Ste 130
Clearwater, FL 33762

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Last Updated On
Contract Detail	AB SPECIALTY PHARMACY INC.	2311 SEVEN SPRINGS BLVD		NEW PORT RICHEY	FL	34655	10/12/2022	01/01/2023	01/01/2023
Contract Detail	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	08/12/2022	10/01/2022	10/01/2022
Contract Detail	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	08/12/2022	10/01/2022	10/01/2022
Contract Detail	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	08/12/2022	10/01/2022	10/01/2022
Contract Detail	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	08/12/2022	10/01/2022	10/01/2022
Contract Detail	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	08/12/2022	10/01/2022	10/01/2022
Contract Detail	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	08/12/2022	10/01/2022	10/01/2022
Contract Detail	ACCREDO HEALTH GROUP, INC.	2825 W PERIMETER RD STE 112		INDIANAPOLIS	IN	46241	08/12/2022	10/01/2022	10/01/2022
Contract Detail	ADVANCED CARE SCRIPTS, INC	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	6251 CHANCELLOR DRIVE SUITE 101	ORLANDO	FL	32809	01/15/2024	04/01/2024	04/01/2024
Contract Detail	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	01/15/2024	04/01/2024	04/01/2024
Contract Detail	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	01/15/2024	04/01/2024	04/01/2024
Contract Detail	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	01/15/2024	04/01/2024	04/01/2024
Contract Detail	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	01/15/2024	04/01/2024	04/01/2024
Contract Detail	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	01/15/2024	04/01/2024	04/01/2024
Contract Detail	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	01/15/2024	04/01/2024	04/01/2024
Contract Detail	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	01/15/2024	04/01/2024	04/01/2024
Contract Detail	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	01/15/2024	04/01/2024	04/01/2024
Contract Detail	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	01/15/2024	04/01/2024	04/01/2024
Contract Detail	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	01/15/2024	04/01/2024	04/01/2024
Contract Detail	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	01/15/2024	04/01/2024	04/01/2024
Contract Detail	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	08/12/2022	10/01/2022	10/01/2022
Contract Detail	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	08/12/2022	10/01/2022	10/01/2022
Contract Detail	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	08/12/2022	10/01/2022	10/01/2022
Contract Detail	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	08/12/2022	10/01/2022	10/01/2022
Contract Detail	OPTUM PHARMACY 700, LLC	5700 DOT COM CT, STE 1000		OVIEDO	FL	32765	01/13/2023	04/01/2023	04/01/2023
Contract Detail	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	01/13/2023	04/01/2023	04/01/2023
Contract Detail	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	01/13/2023	04/01/2023	04/01/2023
Contract Detail	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	01/13/2023	04/01/2023	04/01/2023
Contract Detail	OPTUM PHARMACY 705, LLC	3539 BLUECUTT RD		COLUMBUS	MS	39705	01/13/2023	04/01/2023	04/01/2023
Contract Detail	OPTUM PHARMACY 706, INC.	30-30 47TH AVENUE	SUITE 410	LONG ISLAND CITY	NY	11101	01/13/2023	04/01/2023	04/01/2023
Contract Detail	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	01/13/2023	04/01/2023	04/01/2023
Contract Detail	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	01/15/2024	04/01/2024	04/01/2024
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	01/15/2024	04/01/2024	04/01/2024
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	01/15/2024	04/01/2024	04/01/2024
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	01/15/2024	04/01/2024	04/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	5/31/2023 11:44:40 AM	5/23/2024 2:43:46 PM	5/23/2024 2:43 PM
Details	Last Recertification Date	Update	Recertification		5/31/2023 11:44:40 AM	5/31/2023 11:44 AM
Details	State	Update		Approved	Active	10/1/2022 12:01 AM
Contacts	Signed By	Insert	New Registration		Salyani, Seena CEO West Central Gastroenterology dba Gastro Florida 7273470536	8/12/2022 7:36 AM
Details	340B ID	Update	New Registration		STD335441	8/12/2022 7:36 AM
Dates	Participating Approval Date	Update	New Registration		8/12/2022 7:36:47 AM	8/12/2022 7:36 AM
Details	State	Update	New Registration	Pending	Approved	8/12/2022 7:36 AM
Dates	Signed By Date	Update	New Registration		7/14/2022 4:16:43 PM	8/12/2022 7:36 AM
Dates	Start Date	Update	New Registration		10/1/2022 12:00:00 AM	8/12/2022 7:36 AM
Contacts	Primary Contact	Update	Profile Change Request	Kutner, Jordan Operations and Organizational Development Manager West Central Gastroenterology d.b.a. Gastro Florida 7273470536	Kutner, Jordan Director of Operations West Central Gastroenterology d.b.a. Gastro Florida 7274979152	8/11/2022 2:34 PM
Addresses	Main Address	Insert	New Registration		3821 Maryweather Ln Unit 101 Wesley Chapel, FL 33544	7/14/2022 4:16 PM
Addresses	Billing Address	Insert	New Registration		West Central Gastroenterology dba Gastro Florida 3001 Executive Dr. Ste 130 Clearwater, FL 33762	7/14/2022 4:16 PM
Addresses	Shipping Address	Insert	New Registration		West Central Gastroenterology dba Gastro Florida 3001 Executive Dr. Ste 130 Clearwater, FL 33762	7/14/2022 4:16 PM
Details	Nature of Support: In Kind Support Description	Insert	New Registration		HIV Test Kits, Condoms, Patient Educational Materials	7/14/2022 4:16 PM
Details	Nature Of Support	Insert	New Registration		In-Kind products or services (see note below; must have been purchased with section 318 funds)	7/14/2022 4:16 PM
Details	Nature of Support: Support Received From Date	Insert	New Registration		8/11/2020 12:00:00 AM	7/14/2022 4:16 PM
Details	Nature of Support: Support Received To Date	Insert	New Registration			7/14/2022 4:16 PM
Contacts	Authorizing Official	Insert	New Registration		Salyani, Seena CEO West Central Gastroenterology dba Gastro Florida 7273470536	7/14/2022 4:16 PM
Contacts	Primary Contact	Insert	New Registration		Kutner, Jordan Operations and Organizational Development Manager West Central Gastroenterology d.b.a. Gastro Florida 7273470536	7/14/2022 4:16 PM
Details	Assistance Received From Date	Insert	New Registration			7/14/2022 4:16 PM
Details	Assistance Received To Date	Insert	New Registration			7/14/2022 4:16 PM
Details	Last Recertification Date	Insert	New Registration			7/14/2022 4:16 PM
Details	Grant Number	Insert	New Registration		H25PS005131	7/14/2022 4:16 PM
Details	340B ID	Insert	New Registration			7/14/2022 4:16 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			7/14/2022 4:16 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			7/14/2022 4:16 PM
Details	Medicare Provider Number	Insert	New Registration			7/14/2022 4:16 PM
Details	Entity Name	Insert	New Registration		West Central Gastroenterology dba Gastro Florida	7/14/2022 4:16 PM
Details	NOFO Number	Insert	New Registration		PS19-1901	7/14/2022 4:16 PM
Details	Program Code	Insert	New Registration		STD	7/14/2022 4:16 PM
Details	Entity Subname	Insert	New Registration		Gastro Florida Division 19	7/14/2022 4:16 PM
Dates	Participating Approval Date	Insert	New Registration			7/14/2022 4:16 PM
Details	State	Insert	New Registration		Pending	7/14/2022 4:16 PM
Dates	Registration Date	Insert	New Registration		7/14/2022 4:16:40 PM	7/14/2022 4:16 PM
Dates	Signed By Date	Insert	New Registration			7/14/2022 4:16 PM
Dates	Start Date	Insert	New Registration			7/14/2022 4:16 PM
Terminations	Termination Comments	Insert	New Registration			7/14/2022 4:16 PM
Terminations	Termination Date	Insert	New Registration			7/14/2022 4:16 PM
Terminations	Termination Effective Date	Insert	New Registration			7/14/2022 4:16 PM
Terminations	Termination Reason	Insert	New Registration			7/14/2022 4:16 PM

340B Drug Pricing Program Database

Comments

Medicaid Billing

Shipping Addresses

Contract Pharmacies

History