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CH041294S NORTH BROWARD HOSPITAL DISTRICT (Active)
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Main Details
Name
NORTH BROWARD HOSPITAL DISTRICT
Subdivision Name
Mobile Health Center 2
Type
HRSA-Funded Health Center
Site ID
BPS-H80-038689
340B ID
CH041294S
Grant Number
H80CS00019
Additional Details
Current Program Status
Active
Registration Date
10/7/2024
Participating Start Date
1/1/2025
Participating Approval Date
12/4/2024
Last Recertification Date
2/28/2025
Contacts
Authorizing Official
North Broward Hospital District DBA Broward Health
Alisa Bert, Interim CFO/VP Financial Operations
(954) 847-7483
Primary Contact
North Broward Hospital District dba Broward Health
Dave A Lacknauth, Executive Director of Pharmacy Services
(954) 473-7078
Addresses
Street Address
201 E Sample Rd
Deerfield Beach, FL 33064-3502
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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