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HEMOPHILIA OF GEORGIA
HM32806 Orlando Health, Inc.
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Covered Entity Details
Entity Name
Orlando Health, Inc.
Subdivision Name
Arnold Palmer Hemophilia Treatment Center
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM32806
Entity Address
92 W Miller Street
Orlando, FL 32806
Grant Number
H30MC24046
Participating Start Date
1/1/2018
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
HEMOPHILIA OF GEORGIA
Pharmacy Address
HEMOPHILIA OF GEORGIA
8607 ROBERTS DR STE 150A
SANDY SPRINGS, GA 30350-2238
Pharmacy Comments
Contract Details
Approval Date
7/18/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
BERNADETTE SPONG, CFO
(321) 841-5078
Contract Pharmacy Representative
Hemophilia of Georgia
Maria Manahan, CEO
(770) 518-8272
Signed By Date
7/18/2018
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