340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PUBLIX SUPER MARKETS
DSH100175 DESOTO MEMORIAL HOSPITAL
Print
Covered Entity Details
Entity Name
DESOTO MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH100175
Entity Address
900 NORTH ROBERT AVENUE
ARCADIA, FL 34266
Medicare Provider Number
100175
Participating Start Date
1/1/2008
Last Recertification Date
8/28/2019
Entity Termination Date
10/1/2020
Pharmacy Details
Pharmacy Name
PUBLIX SUPER MARKETS
Pharmacy Address
PUBLIX PHARMACY #0828
2875 UNIVERSITY PARKWAY
SARASOTA, FL 34243
Pharmacy Comments
Contract Details
Approval Date
7/15/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Daniel P. Hogan, CFO
(863) 494-8414
Contract Pharmacy Representative
Publix
Kimberely Bone, Sr Director of 340B
(863) 688-1188 Ext: 52364
Signed By Date
7/15/2019
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session