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PRIME THERAPEUTICS SPECIALTY PHARMACY LL
STD336072 Hope and Help Center of Central Florida, Inc.
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Covered Entity Details
Entity Name
Hope and Help Center of Central Florida, Inc.
Subdivision Name
Diversity Health Center of Tampa Bay
Type
Sexually Transmitted Diseases
340B ID
STD336072
Entity Address
4302 N. Habana Ave.
Suite 200
Tampa, FL 33607-6368
Grant Number
NH25PS005131
Participating Start Date
4/1/2018
Last Recertification Date
5/6/2025
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
7/15/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
Lisa Barr, Executive Director
(407) 645-2577 Ext: 121
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/15/2020
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