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PRIME THERAPEUTICS SPECIALTY PHARMACY LL
CHC28988-00 DAP HEALTH INC
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Covered Entity Details
Entity Name
DAP HEALTH INC
Subdivision Name
Desert AIDS Project, Inc.
Type
HRSA-Funded Health Center
340B ID
CHC28988-00
Entity Address
1695 N Sunrise Way
Palm Springs, CA 92262-3701
Grant Number
H80CS28988
Participating Start Date
4/1/2016
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
PRIME THERAPEUTICS SPECIALTY PHARMACY LL
Pharmacy Address
ALLIANCERX WALGREENS PRIME #16568
2354 COMMERCE PARK DRIVE
SUITE 100
ORLANDO, FL 32819-9992
Pharmacy Comments
Contract Details
Approval Date
10/10/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
David Brinkman, Chief Executive Officer
(760) 992-0418
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/10/2019
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