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URBAN SPECIALTY PHARMACY, LLC
STD34652 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
NPR
Type
Sexually Transmitted Diseases
340B ID
STD34652
Entity Address
4758 Rowan Road
New Port Richey, FL 34653
Grant Number
1 NH25PS005131-01-00
Participating Start Date
10/1/2017
Last Recertification Date
5/28/2025
Pharmacy Details
Pharmacy Name
URBAN SPECIALTY PHARMACY, LLC
Pharmacy Address
1617 34TH ST S STE A
ST PETERSBURG, FL 33711-2855
Pharmacy Comments
Contract Details
Approval Date
1/22/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Richard E. Carlisle, President & CEO
(941) 366-0134 Ext: 11111
Contract Pharmacy Representative
Urban Specialty Pharmacy
Paresh Shukla, PIC
(813) 928-4382
Signed By Date
1/22/2019
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