Covered Entity Details

STD3280612 Sunshine Specialty Health Outreach Foundation (Active) - information as of 5/16/2025 11:35:40 PM

Main Details

Name

Sunshine Specialty Health Outreach Foundation

Subdivision Name

Type

Sexually Transmitted Diseases

340B ID

STD3280612

Grant Number

5nu62ps924532-02

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.
Currently, HIV Rapid Testing Kits, HCV Rapid Testing Kits, Condoms, and Sexually Transmitted Diseases Education material
1/1/2025 - 12/31/2026

Additional Details

Current Program Status

Active

Registration Date

9/28/2022

Participating Start Date

10/12/2022

Participating Approval Date

10/12/2022

Last Recertification Date

5/5/2025

Notice of Funding Opportunity (NOFO) Number

ps18-1802

Contacts

Authorizing Official

Sunshine Specialty Health Outreach Foundation
Jillian Hall, President
(407) 325-1299

Primary Contact

Sunshine Specialty Health Outreach Foundation
Romny Rejouis, Treasurer
(321) 805-0684

Addresses

Street Address

220 E. Gore St
Orlando, FL 32806

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	ADVANCED CARE SCRIPTS, INC	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	6251 CHANCELLOR DRIVE SUITE 101	ORLANDO	FL	32809	07/08/2024	10/01/2024		10/01/2024
Contract Detail	AVITA DRUGS FLORIDA, LLC DBA AVITA PHARM	8601 COMMODITY CIR, SUITE 105		ORLANDO	FL	32819-9003	10/12/2022	10/12/2022	05/07/2025	05/16/2025
Contract Detail	AVITA DRUGS FLORIDA, LLC DBA AVITA PHARM	1409 NE 26TH ST		WILTON MANORS	FL	33305	10/12/2022	10/12/2022	05/07/2025	05/16/2025
Contract Detail	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	10/12/2022	10/12/2022	05/07/2025	05/16/2025
Contract Detail	AVITA PHARMACY 1047	AVITA DRUGS FLORIDA LLC D/B/A AVITA PHAR	1110 KEVSTIN DR	KISSIMMEE	FL	34744	10/12/2022	10/12/2022	05/07/2025	05/16/2025
Contract Detail	BAILEY'S PHARMACY	MEDICAL HOTSPOTS, INC	3850 W COMMERCIAL BLVD STE B	FORT LAUDERDALE	FL	33309	04/14/2025	07/01/2025		04/14/2025
Contract Detail	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	10/12/2022	10/12/2022		10/12/2022
Contract Detail	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	01/05/2023	04/01/2023		04/01/2023
Contract Detail	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	01/05/2023	04/01/2023		04/01/2023
Contract Detail	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	01/05/2023	04/01/2023		04/01/2023
Contract Detail	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	01/05/2023	04/01/2023		04/01/2023
Contract Detail	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	01/05/2023	04/01/2023		04/01/2023
Contract Detail	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	01/05/2023	04/01/2023		04/01/2023
Contract Detail	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	01/05/2023	04/01/2023		04/01/2023
Contract Detail	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	01/05/2023	04/01/2023		04/01/2023
Contract Detail	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	01/05/2023	04/01/2023		04/01/2023
Contract Detail	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	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	01/05/2023	04/01/2023		04/01/2023
Contract Detail	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	10/12/2022	10/12/2022		10/12/2022
Contract Detail	HEALTHYRX PHARMACY LLC	DBA-HEALTHYRX PHARMACY	650 NW 120TH ST	NORTH MIAMI	FL	33168	09/22/2023	09/22/2023	04/15/2025	04/21/2025
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 04491	9306 NARCOOSSEE RD.	ORLANDO	FL	32827	10/12/2022	10/12/2022		10/12/2022
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 00190	3212 CURRY FORD RD	ORLANDO	FL	32806	10/12/2022	10/12/2022		10/12/2022
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03492	4315 CURRY FORD RD.	ORLANDO	FL	32806	10/12/2022	10/12/2022		10/12/2022
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 07889	8025 LEE VISTA BLVD	ORLANDO	FL	32829	01/05/2023	04/01/2023		04/01/2023
Contract Detail	HOLIDAY CVS, L.L.C.	CVS PHARMACY # 16179	718 MAGUIRE BLVD	ORLANDO	FL	32803	01/05/2023	04/01/2023		04/01/2023
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03351	7300 CURRY FORD RD.	ORLANDO	FL	32822	01/05/2023	04/01/2023		04/01/2023
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 04645	2351 S HIAWASSEE RD	ORLANDO	FL	32835	01/05/2023	04/01/2023		04/01/2023
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03141	5190 S CONWAY RD	ORLANDO	FL	32812	01/05/2023	04/01/2023		04/01/2023
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 01314	1201 E COLONIAL DR	ORLANDO	FL	32803	01/05/2023	04/01/2023		04/01/2023
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03921	12077 SOUTH ORANGE BLOSSOM TRAIL	ORLANDO	FL	32837	01/05/2023	04/01/2023		04/01/2023
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 02829	3502 EDGEWATER DR.	ORLANDO	FL	32804	01/05/2023	04/01/2023		04/01/2023
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 04614	7451 E COLONIAL DR	ORLANDO	FL	32807	01/05/2023	04/01/2023		04/01/2023
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05901	7001 OLD WINTER GARDEN RD.	ORLANDO	FL	32835	01/05/2023	04/01/2023		04/01/2023
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 07921	4801 NEW BROAD ST.	ORLANDO	FL	32814	01/05/2023	04/01/2023		04/01/2023
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05216	2702 S ORANGE AVE	ORLANDO	FL	32806	01/10/2023	04/01/2023		04/01/2023
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 00521	2201 EDGEWATER DR	ORLANDO	FL	32804	01/10/2023	04/01/2023	07/03/2023	07/03/2023
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 00204	5899 ORANGE BLOSSOM TRL	ORLANDO	FL	32839	01/10/2023	04/01/2023		04/01/2023
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03145	5886 CONROY RD.	ORLANDO	FL	32835	01/10/2023	04/01/2023	07/18/2023	08/15/2023
Contract Detail	HOLIDAY CVS, L.L.C.	CVS PHARMACY # 16848	4750 MILLENIA PLAZA WAY	ORLANDO	FL	32839	01/10/2023	04/01/2023		04/01/2023
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05077	5300 S JOHN YOUNG PKWY	ORLANDO	FL	32839	01/10/2023	04/01/2023		04/01/2023
Contract Detail	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 07219	277 W. SR 436	ALTAMONTE SPRINGS	FL	32714	04/16/2023	07/01/2023		07/01/2023
Contract Detail	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	10/12/2022	10/12/2022	05/07/2025	05/16/2025
Contract Detail	MEDICAL HOTSPOTS, INC	BAILEY'S PHARMACY	780 US HIGHWAY 1 UNIT 101	VERO BEACH	FL	32962-1661	04/14/2025	07/01/2025		04/14/2025
Contract Detail	MEDICAL HOTSPOTS, INC	BAILEY'S PHARMACY	5156 S ORANGE AVE STE B	ORLANDO	FL	32809	04/14/2025	07/01/2025		04/14/2025
Contract Detail	MEDICAL HOTSPOTS, INC	BAILEY'S PHARMACY	3065 34TH ST N STE B	ST PETERSBURG	FL	33713-2401	04/14/2025	07/01/2025		04/14/2025
Contract Detail	PHARMA BUDDIES CORP	ROSEMONT SPECIALTY PHARMACY	1727 ORLANDO CENTRAL PKWY	ORLANDO	FL	32809	10/12/2022	10/12/2022	04/12/2025	04/21/2025
Contract Detail	PHARMA BUDDIES CORP	ROSEMONT SPECIALTY PHARMACY	1727 ORLANDO CENTRAL PKWY	ORLANDO	FL	32809	10/12/2022	10/12/2022	04/12/2025	04/21/2025
Contract Detail	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	10/12/2022	10/12/2022		10/12/2022
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	01/05/2023	04/01/2023		04/01/2023
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	01/05/2023	04/01/2023		04/01/2023
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	01/05/2023	04/01/2023		04/01/2023
Contract Detail	PROCARE PHARMACY, L.L.C.	NAVARRO SPECIALTY SERVICES # 10727	7205 CORPORATE CENTER DRIVE SUITE 104	MIAMI	FL	33126	01/10/2023	04/01/2023		04/01/2023
Contract Detail	PUBLIX PHARMACY	PUBLIX PHARMACY #0436	2873 S. ORANGE AVE	ORLANDO	FL	32806	04/16/2023	07/01/2023		07/01/2023
Contract Detail	PUBLIX SUPER MARKETS, INC.	PUBLIX PHARMACY #1501	4042 S. SEMORAN BLVD	ORLANDO	FL	32822	04/16/2023	07/01/2023		07/01/2023
Contract Detail	PUBLIX SUPER MARKETS, INC.	PUBLIX CENTRAL PHARMACY #3201	2424 ORLANDO CENTRAL PARKWAY	ORLANDO	FL	32809	04/16/2023	07/01/2023		07/01/2023
Contract Detail	PUBLIX SUPER MARKETS, INC.	PUBLIX PHARMACY #3213	1950 SAND LAKE RD, BLDG #5	ORLANDO	FL	32809	04/16/2023	07/01/2023		07/01/2023
Contract Detail	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	07/15/2024	10/01/2024		10/01/2024
Contract Detail	WAL-MART PHARMACY #10-5871	5734 S. ORANGE BLOSSOM TRAIL		ORLANDO	FL	32809	07/15/2024	10/01/2024		10/01/2024
Contract Detail	WAL-MART PHARMACY 10-0908	8101 SO. JOHN YOUNG PKWY.		ORLANDO	FL	32819	07/15/2024	10/01/2024		10/01/2024
Contract Detail	WAL-MART PHARMACY 10-3617	600 SOUTH ALAFAYA TRAIL		ORLANDO	FL	32828	07/15/2024	10/01/2024		10/01/2024
Contract Detail	WAL-MART PHARMACY 10-5315	2354 COMMERCE PARK DR.		ORLANDO	FL	32819	07/15/2024	10/01/2024		10/01/2024
Contract Detail	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	07/15/2024	10/01/2024		10/01/2024
Contract Detail	WAL-MART PHARMACY WHSE #45	2250 NORTH 8TH STREET	SUITE 102-A	ROGERS	AR	72756	07/15/2024	10/01/2024		10/01/2024
Contract Detail	WALGREEN CO	DBA: WALGREENS #10556	5903 S ORANGE BLOSSOM TRAIL	ORLANDO	FL	32809	10/12/2022	10/12/2022		10/12/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS SPECIALTY PHARMACY #12146	1200 KUHL AVE	ORLANDO	FL	32806	10/12/2022	10/12/2022		10/12/2022
Contract Detail	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #15300	2100 N ORANGE AVE STE B	ORLANDO	FL	32804	10/12/2022	10/12/2022		10/12/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 05658	408 E MICHIGAN STREET	ORLANDO	FL	32806	10/12/2022	10/12/2022		10/12/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03650	2420 E COLONIAL DRIVE	ORLANDO	FL	32803	10/12/2022	10/12/2022		10/12/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03811	4502 S ORANGE BLOSSOM TRAIL	ORLANDO	FL	32839-1704	10/12/2022	10/12/2022	03/20/2023	06/24/2024
Contract Detail	WALGREEN CO.	DBA: WALGREENS #16514	4300 CURRY FORD RD	ORLANDO	FL	32806-2700	10/12/2022	10/12/2022		10/12/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 04961	1669 E SILVER STAR RD	OCOEE	FL	34761	01/11/2023	04/01/2023		04/01/2023
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03745	5185 NORTH LANE	ORLANDO	FL	32808	04/08/2024	07/01/2024		07/01/2024
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 12672	1835 SAND LAKE RD	ORLANDO	FL	32809	04/08/2024	07/01/2024	12/17/2024	01/08/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 04906	5280 S JOHN YOUNG PKWY	ORLANDO	FL	32839	04/10/2024	07/01/2024		07/01/2024
Contract Detail	Walgreens #21395	Walgreens Central Fill #21395	5710 Young Pine Rd	Orlando	FL	32829	10/12/2022	10/12/2022		10/12/2022
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	10/12/2022	10/12/2022		10/12/2022
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	10/12/2022	10/12/2022		10/12/2022
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	10/12/2022	10/12/2022		10/12/2022
Contract Detail	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	07/15/2024	10/01/2024		10/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Nature of Support: In Kind Support Description	Update	Recertification	HIV Rapid Testing Kits, HCV Rapid Testing Kits, Condoms, and Sexually Transmitted Diseases Education material	Currently, HIV Rapid Testing Kits, HCV Rapid Testing Kits, Condoms, and Sexually Transmitted Diseases Education material	5/5/2025 3:32 PM
Details	Last Recertification Date	Update	Recertification	5/7/2024 2:43:21 PM	5/5/2025 3:32:38 PM	5/5/2025 3:32 PM
Contacts	Primary Contact	Update	Change Request	Rejouis, Romny Treasurer Sunshine Specialty Health Outreach Foundation 3218050684	Rejouis, Romny Treasurer Sunshine Specialty Health Outreach Foundation 3218050684	4/10/2025 6:22 AM
Contacts	Authorizing Official	Update	Change Request	Hall, Jillian President Sunshine Specialty Health Outreach Foundation 4073251299	Hall, Jillian President Sunshine Specialty Health Outreach Foundation 4073251299	4/10/2025 6:22 AM
Addresses	Main Address	Update	Change Request	1727 Orlando Central Parkway Suite 201 Orlando, FL 32809	220 E. Gore St Orlando, FL 32806	4/7/2025 7:38 AM
Medicaid Billing	Medicaid: Number	Delete	Change Request	114297900 (FL)		4/7/2025 7:38 AM
Medicaid Billing	NPI: Number	Delete	Change Request	1043986979 (FL)		4/7/2025 7:38 AM
Details	Nature of Support: Support Received From Date	Update	Change Request	1/1/2022 12:00:00 AM	1/1/2025 12:00:00 AM	2/3/2025 6:58 AM
Details	Nature of Support: Support Received To Date	Update	Change Request	12/31/2024 12:00:00 AM	12/31/2026 12:00:00 AM	2/3/2025 6:58 AM
Contacts	Authorizing Official	Update	Change Request	Hall, Jillian CEO Sunshine Specialty Health Care, LLC 4078885980	Hall, Jillian President Sunshine Specialty Health Outreach Foundation 4073251299	2/3/2025 6:58 AM
Contacts	Primary Contact	Update	Change Request	Kilian, Nelly Administrative Assistant Sunshine Specialty Health Care, LLC 4078885980	Rejouis, Romny Treasurer Sunshine Specialty Health Outreach Foundation 3218050684	2/3/2025 6:58 AM
Details	Entity Name	Update	Change Request	Sunshine Specialty Health Care	Sunshine Specialty Health Outreach Foundation	2/3/2025 6:58 AM
Details	Last Recertification Date	Update	Recertification	5/9/2023 3:08:01 PM	5/7/2024 2:43:21 PM	5/7/2024 2:43 PM
Contacts	Primary Contact	Update	Change Request	Kilian, Nelly Administrative Assistant Sunshine Specialty Health Care, LLC 4078885980	Kilian, Nelly Administrative Assistant Sunshine Specialty Health Care, LLC 4078885980	4/8/2024 1:45 PM
Contacts	Authorizing Official	Update	Change Request	Hall, Jillian CEO Sunshine Specialty Health Care, LLC 4078885980	Hall, Jillian CEO Sunshine Specialty Health Care, LLC 4078885980	4/8/2024 1:45 PM
Contacts	Authorizing Official	Update	AO Change Request	Hall, Jillian CEO Sunshine Specialty Health Care, LLC 4078885980	Hall, Jillian CEO Sunshine Specialty Health Care, LLC 4078885980	4/8/2024 11:27 AM
Addresses	Main Address	Update	Change Request	1727 Orlando Central Parkway Orlando, FL 32809	1727 Orlando Central Parkway Suite 201 Orlando, FL 32809	5/25/2023 7:25 AM
Details	Nature of Support: In Kind Support Description	Update	Change Request	Receive HIV Rapid Testing Kits, HCV Rapid Testing Kits, Condoms, and Sexually Transmitted Diseases Education	HIV Rapid Testing Kits, HCV Rapid Testing Kits, Condoms, and Sexually Transmitted Diseases Education material	5/25/2023 7:25 AM
Contacts	Authorizing Official	Update	Change Request	Hall, Jillian President Sunshine Specialty Health Outreach Foundation 4073251299	Hall, Jillian CEO Sunshine Specialty Health Care, LLC 4078885980	5/25/2023 7:25 AM
Contacts	Primary Contact	Update	Change Request	Rejouis, Romny Treasurer Sunshine Specialty Health Outreach Foundation 3218050684	Kilian, Nelly Administrative Assistant Sunshine Specialty Health Care, LLC 4078885980	5/25/2023 7:25 AM
Details	Entity Name	Update	Change Request	Sunshine Specialty Health Outreach Foundation	Sunshine Specialty Health Care	5/25/2023 7:25 AM
Details	Entity Subname	Update	Change Request	Sunshine Specialty Health Care		5/25/2023 7:25 AM
Details	Last Recertification Date	Update	Recertification		5/9/2023 3:08:01 PM	5/9/2023 3:08 PM
Addresses	Main Address	Update	Change Request	2884 S. Osceola Avenue Orlando, FL 32806	1727 Orlando Central Parkway Orlando, FL 32809	5/9/2023 8:53 AM
Details	Entity Subname	Update	Change Request		Sunshine Specialty Health Care	10/19/2022 10:33 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	10/13/2022 10:25 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		114297900	10/13/2022 10:25 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		FL	10/13/2022 10:25 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1043986979	10/13/2022 10:25 AM
Medicaid Billing	NPI: State	Insert	Change Request		FL	10/13/2022 10:25 AM
Details	State	Update	OPA Edit	Approved	Active	10/12/2022 7:38 AM
Dates	Start Date	Update	OPA Edit	1/1/2023 12:00:00 AM	10/12/2022 12:00:00 AM	10/12/2022 7:38 AM
Contacts	Signed By	Insert	New Registration		Hall, Jillian President Sunshine Specialty Health Outreach Foundation 4073251299	10/12/2022 7:33 AM
Details	340B ID	Update	New Registration		STD3280612	10/12/2022 7:33 AM
Dates	Participating Approval Date	Update	New Registration		10/12/2022 7:33:48 AM	10/12/2022 7:33 AM
Details	State	Update	New Registration	Pending	Approved	10/12/2022 7:33 AM
Dates	Signed By Date	Update	New Registration		9/28/2022 3:55:29 PM	10/12/2022 7:33 AM
Dates	Start Date	Update	New Registration		1/1/2023 12:00:00 AM	10/12/2022 7:33 AM
Addresses	Main Address	Insert	New Registration		2884 S. Osceola Avenue Orlando, FL 32806	9/28/2022 3:55 PM
Details	Nature of Support: In Kind Support Description	Insert	New Registration		Receive HIV Rapid Testing Kits, HCV Rapid Testing Kits, Condoms, and Sexually Transmitted Diseases Education	9/28/2022 3:55 PM
Details	Nature Of Support	Insert	New Registration		In-Kind products or services (see note below; must have been purchased with section 318 funds)	9/28/2022 3:55 PM
Details	Nature of Support: Support Received From Date	Insert	New Registration		1/1/2022 12:00:00 AM	9/28/2022 3:55 PM
Details	Nature of Support: Support Received To Date	Insert	New Registration		12/31/2024 12:00:00 AM	9/28/2022 3:55 PM
Contacts	Authorizing Official	Insert	New Registration		Hall, Jillian President Sunshine Specialty Health Outreach Foundation 4073251299	9/28/2022 3:55 PM
Contacts	Primary Contact	Insert	New Registration		Rejouis, Romny Treasurer Sunshine Specialty Health Outreach Foundation 3218050684	9/28/2022 3:55 PM
Details	Assistance Received From Date	Insert	New Registration			9/28/2022 3:55 PM
Details	Assistance Received To Date	Insert	New Registration			9/28/2022 3:55 PM
Details	Last Recertification Date	Insert	New Registration			9/28/2022 3:55 PM
Details	Grant Number	Insert	New Registration		5nu62ps924532-02	9/28/2022 3:55 PM
Details	340B ID	Insert	New Registration			9/28/2022 3:55 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			9/28/2022 3:55 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			9/28/2022 3:55 PM
Details	Medicare Provider Number	Insert	New Registration			9/28/2022 3:55 PM
Details	Entity Name	Insert	New Registration		Sunshine Specialty Health Outreach Foundation	9/28/2022 3:55 PM
Details	NOFO Number	Insert	New Registration		ps18-1802	9/28/2022 3:55 PM
Details	Program Code	Insert	New Registration		STD	9/28/2022 3:55 PM
Details	Entity Subname	Insert	New Registration			9/28/2022 3:55 PM
Dates	Participating Approval Date	Insert	New Registration			9/28/2022 3:55 PM
Details	State	Insert	New Registration		Pending	9/28/2022 3:55 PM
Dates	Registration Date	Insert	New Registration		9/28/2022 3:55:26 PM	9/28/2022 3:55 PM
Dates	Signed By Date	Insert	New Registration			9/28/2022 3:55 PM
Dates	Start Date	Insert	New Registration			9/28/2022 3:55 PM
Terminations	Termination Comments	Insert	New Registration			9/28/2022 3:55 PM
Terminations	Termination Date	Insert	New Registration			9/28/2022 3:55 PM
Terminations	Termination Effective Date	Insert	New Registration			9/28/2022 3:55 PM
Terminations	Termination Reason	Insert	New Registration			9/28/2022 3:55 PM

340B Drug Pricing Program Database

Comments

Medicaid Billing

Shipping Addresses

Contract Pharmacies

History