Pharmacy Details

PRIME THERAPEUTICS PHARMACY LLC - information as of 6/27/2025 12:55:37 AM

Name
PRIME THERAPEUTICS PHARMACY LLC

Address

6870 SHADOWRIDGE DR STE 111
ORLANDO, FL 32812

Comments

Contracts
History

Contracts

Contract Detail	340B ID	Entity Name	Sub Name	Entity Type	Address	Address Cont.	City	State	Begin Date	Term Date	Edit Date
Details	CH021630	COMMUNITY HEALTHCARE NETWORK	COMMUNITY HEALTHCARE NETWORK	HRSA-Funded Health Center	60 MADSION AVE	5TH FLOOR	NEW YORK	NY	10/01/2016	08/07/2018	8/7/2018 12:48 PM
Details	CH022110	THE ADDABBO JOSEPH P FAMILY HEALTH CENTER INC	JOSEPH P. ADDABBO FAMILY HEALTH CENTER	HRSA-Funded Health Center	6200 Beach Channel Dr		Arverne	NY	01/01/2017	01/01/2017	7/28/2020 5:29 PM
Details	DSH100113	SHANDS TEACHING HOSPITAL AND CLINICS, INC.		Disproportionate Share Hospital	1600 SW Archer Road		GAINESVILLE	FL	01/01/2013	08/01/2015	2/29/2016 5:20 PM
Details	DSH330024	THE MOUNT SINAI HOSPITAL		Disproportionate Share Hospital	ONE GUSTAVE L. LEVY PLACE		NEW YORK	NY	10/01/2016	07/15/2016	7/24/2017 6:49 PM
Details	DSH330046	MOUNT SINAI WEST		Disproportionate Share Hospital	1000 TENTH AVENUE		NEW YORK	NY	10/01/2016	07/15/2016	8/3/2017 10:15 AM
Details	DSH330169	MOUNT SINAI BETH ISRAEL		Disproportionate Share Hospital	FIRST AVENUE AT 16TH STREET		NEW YORK	NY	10/01/2016	07/15/2016	7/25/2017 11:18 AM

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Addresses	Pharmacy Address	Update		MAGELLAN RX PHARMACY, LLC 6870 SHADOWRIDGE DR. SUITE 111 ORLANDO, FL 32812-9002	PRIME THERAPEUTICS PHARMACY LLC 6870 SHADOWRIDGE DR STE 111 ORLANDO, FL 32812	10/14/2024 3:08 PM
Details	Name	Update		MAGELLAN RX PHARMACY, LLC	PRIME THERAPEUTICS PHARMACY LLC	10/14/2024 3:08 PM
Addresses	Pharmacy Address	Insert			MAGELLAN RX PHARMACY, LLC 6870 SHADOWRIDGE DR. SUITE 111 ORLANDO, FL 32812-9002	9/29/2017 6:44 AM
Addresses	Pharmacy Address	Update		ICORE HEALTHCARE LLC 6870 SHADOWRIDGE DR. ORLANDO, FL 32812-9002	MAGELLAN RX PHARMACY, LLC 6870 SHADOWRIDGE DR. SUITE 111 ORLANDO, FL 32812-9002	3/16/2015 10:36 AM
Details	Name	Update		ICORE HEALTHCARE LLC	MAGELLAN RX PHARMACY, LLC	3/16/2015 10:36 AM
Addresses	Pharmacy Address	Update		ICORE HEALTHCARE LLC 855 SW 78TH AVE PLANTATION, FL 33324	ICORE HEALTHCARE LLC 6870 SHADOWRIDGE DR. ORLANDO, FL 32812-9002	7/3/2013 9:03 AM
Details	Comments	Update				3/28/2013 4:12 PM
Addresses	Pharmacy Address	Update		ICORE HEALTHCARE LLC 855 SW 78TH AVE SUITE 110 PLANTATION, FL 33324	ICORE HEALTHCARE LLC 855 SW 78TH AVE PLANTATION, FL 33324	3/28/2013 4:12 PM
Addresses	Pharmacy Address	Update		Icore Healthcare, LLC 855 SW 78th Avenue, Suite 110 Plantation, FL 33324	ICORE HEALTHCARE LLC 855 SW 78TH AVE SUITE 110 PLANTATION, FL 33324	11/28/2012 5:02 PM
Details	Name	Update		Icore Healthcare, LLC	ICORE HEALTHCARE LLC	11/28/2012 5:02 PM