Covered Entity Details

FP323993 FLORIDA DEPARTMENT OF HEALTH (Active)

Main Details

Name

FLORIDA DEPARTMENT OF HEALTH

Subdivision Name

Type

Family Planning (Title X only)

340B ID

FP323993

Grant Number

FPHPA006543

Additional Details

Current Program Status

Active

Registration Date

1/1/1998

Participating Start Date

1/1/1998

Participating Approval Date

12/1/2008

Last Recertification Date

5/17/2024

Contacts

Authorizing Official

Florida Department of Health
Niaz Siddiqui, Bureau Chief
(850) 922-9036 Ext: 3010

Primary Contact

Department of Health
Isaiah Hill, Government Operations Consultant II
(850) 922-9036

Addresses

Street Address

4052 BALD CYPRESS WAY
TALLAHASSEE, FL 32399

Billing Address

FLORIDA DEPARTMENT OF HEALTH
104-2 HAMILTON PARK DRIVE
TALLAHASSEE, FL 32304

Comment	Last Updated On
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7/17/13 termination was in error, reversed; 6/5/13 terminated becuase site is a pharmacy only; 1/29/09 UPDATED SHIP TO (WAS FLORIDA DEPARTMENT OF HEALTH DEPT OF HEALTH CENTRAL PHARMACY, 2818 MAHAN DRIVE) AND UPDATED ADDR (WAS 116 HAMILTON PARK DRIVE); 1/21/09 UPDATED ADDR (WAS 2818 MAHAN DRIVE;32308); 12/5/08 UPDATED ADDR (WAS 116 HAMILTON PARK DR) AND REMOVED SUBDIV NAME (WAS CENTRAL PHARMACY SERVICES DEPARTMENT AGENT); 12/1/08 UPDATED SUBDIV NAME (WAS CENTRAL PHARMACY SERVICES DEPARTMENT AGENT) AND UPDATED ADDR (WAS 2818 MAHAN DRIVE AND ZIP 32308); 7/28/08 ADDED MEDICAID #	07/17/2013
1/29/09 UPDATED SHIP TO (WAS FLORIDA DEPARTMENT OF HEALTH DEPT OF HEALTH CENTRAL PHARMACY, 2818 MAHAN DRIVE) AND UPDATED ADDR (WAS 116 HAMILTON PARK DRIVE); 1/21/09 UPDATED ADDR (WAS 2818 MAHAN DRIVE;32308); 12/5/08 UPDATED ADDR (WAS 116 HAMILTON PARK DR) AND REMOVED SUBDIV NAME (WAS CENTRAL PHARMACY SERVICES DEPARTMENT AGENT); 12/1/08 UPDATED SUBDIV NAME (WAS CENTRAL PHARMACY SERVICES DEPARTMENT AGENT) AND UPDATED ADDR (WAS 2818 MAHAN DRIVE AND ZIP 32308); 7/28/08 ADDED MEDICAID #	03/01/2010

340B Drug Pricing Program Database