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PHARMACY CARE
RWI33316 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
BH Central
Type
Ryan White Part A
340B ID
RWI33316
Entity Address
1726 SE 3rd Ave
Ft. Lauderdale, FL 33316
Grant Number
H89HA00002
Participating Start Date
10/1/2017
Last Recertification Date
2/25/2022
Entity Termination Date
10/1/2022
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
Contract Termination Date
Termination Reason
10/1/2022
Covered Entity Terminated
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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