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PUBLIX PHARMACY #0696
STD342391 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Osprey
Type
Sexually Transmitted Diseases
340B ID
STD342391
Entity Address
1425 South Osprey Ave.
Sarasota, FL 34239
Grant Number
1 NH25PS005131-01-00
Participating Start Date
4/1/2016
Last Recertification Date
5/27/2024
Pharmacy Details
Pharmacy Name
PUBLIX PHARMACY #0696
Pharmacy Address
PUBLIX SUPER MARKETS INC
6543 S TAMIAMI TRAIL
SARASOTA, FL 34231
Pharmacy Comments
Contract Details
Approval Date
1/22/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard E. Carlisle, President & CEO
(941) 366-0134 Ext: 11111
Contract Pharmacy Representative
Publix
Fred Ottolino, VP of Pharmacy Operations
(863) 688-1188 Ext: 52352
Signed By Date
1/22/2019
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