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RWII34982D Midway Specialty Care Center Inc (Terminated)
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Main Details
Name
Midway Specialty Care Center Inc
Subdivision Name
Type
Ryan White Part B
340B ID
RWII34982D
Grant Number
X07HA00057
Additional Details
Current Program Status
Terminated
Registration Date
1/14/2020
Participating Start Date
4/1/2020
Participating Approval Date
2/25/2020
Last Recertification Date
2/20/2023
Time Period the Assistance was Received
3/1/2017 - 3/31/2023
Termination Date
Termination Reason
4/1/2024
Business decision by the Covered Entity
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
1434 Kennedy Drive
Key West, FL 33040
Billing Address
Midway Specialty Care Center Inc
356 E MIDWAY RD
Fort Pierce, FL 34982
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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