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CAN COMMUNITY HEALTH, INC.
FQHCLA407C Metropolitan Charities, Inc.
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Covered Entity Details
Entity Name
Metropolitan Charities, Inc.
Subdivision Name
METRO St. Petersburg
Type
Health Center Program Look-Alike
340B ID
FQHCLA407C
Entity Address
3251 3rd Ave N
Saint Petersburg, FL 33713-8506
Grant Number
LALCS35348
Participating Start Date
4/14/2020
Last Recertification Date
2/9/2023
Entity Termination Date
4/1/2024
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
4/14/2020
Contract Begin Date
4/21/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2024
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
4/8/2020
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