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RWII34982B Midway Specialty Care Center Inc (Active)
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Main Details
Name
Midway Specialty Care Center Inc
Subdivision Name
Type
Ryan White Part B
340B ID
RWII34982B
Grant Number
X07HA00057
Additional Details
Current Program Status
Active
Registration Date
7/10/2018
Participating Start Date
10/1/2018
Participating Approval Date
8/22/2018
Last Recertification Date
2/12/2025
Time Period the Assistance was Received
3/1/2017 - 6/30/2025
Contacts
Authorizing Official
Midway Specialty Care Center Inc
Kathryn E Hayden, CFO
(772) 742-9276
Primary Contact
Midway Specialty Care Center
Anand Sukhram, CEO
(772) 464-9746
Addresses
Street Address
1801 SE Hillmoor Drive
C207
Port St Lucie, FL 34952
Billing Address
Midway Specialty Care Center Inc
356 E Midway Road
Fort Pierce, FL 34982
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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