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CAN COMMUNITY HEALTH, INC.
STD337111 Metropolitan Charities, Inc.
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Covered Entity Details
Entity Name
Metropolitan Charities, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD337111
Entity Address
4601 34th Street South
Suite 102
St Petersburg, FL 33711
Grant Number
5NU65PS004814-05-00
Participating Start Date
7/1/2019
Last Recertification Date
Entity Termination Date
10/1/2019
Pharmacy Details
Pharmacy Name
CAN COMMUNITY HEALTH, INC.
Pharmacy Address
CAN COMMUNITY HEALTH PHARMACY OF CLEARWA
2349 SUNSET POINT RD STE 404
CLEARWATER, FL 33765
Pharmacy Comments
Contract Details
Approval Date
7/8/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Priya Rajkumar, Chief Executive Officer
(727) 321-3854 Ext: 1230
Contract Pharmacy Representative
CAN Community Health, Inc.
Richard E. Carlisle, President & CEO
(941) 366-0134 Ext: 11111
Signed By Date
7/8/2019
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