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PHARMACY CARE
STD333341 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Dixie Hwy
Type
Sexually Transmitted Diseases
340B ID
STD333341
Entity Address
5333 N. Dixie Hwy
Suite 110
Fort Lauderdale, FL 33334
Grant Number
1 NH25PS005131-01-00
Participating Start Date
1/1/2018
Last Recertification Date
5/29/2025
Pharmacy Details
Pharmacy Name
PHARMACY CARE
Pharmacy Address
DBA: THE MEDICINE SHOPPE
1905 N ANDREWS AVE
WILTON MANORS, FL 33311-3914
Pharmacy Comments
Contract Details
Approval Date
4/23/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard E. Carlisle, President & CEO
(941) 366-0461 Ext: 11111
Contract Pharmacy Representative
PHARMACY CARE
LYNN WILLIAMS, OWNER
(954) 563-8407
Signed By Date
4/23/2018
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