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CCN AMERICA, LP
HV01312A University of Florida CARES
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Covered Entity Details
Entity Name
University of Florida CARES
Subdivision Name
University of Florida CARES Emerson
Type
Ryan White Part C
340B ID
HV01312A
Entity Address
4555 Emerson Street
Jacksonville, FL 32207
Grant Number
H76HA01312
Participating Start Date
7/1/2019
Last Recertification Date
2/8/2022
Entity Termination Date
1/1/2023
Pharmacy Details
Pharmacy Name
CCN AMERICA, LP
Pharmacy Address
COORDINATED CARE NETWORK PHARMACY
1500 W CYPRESS CREEK RD STE 203
FT LAUDERDALE, FL 33309
Pharmacy Comments
Contract Details
Approval Date
8/7/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Tina M. Bottini, Senior Asst. Dean, Research
(904) 244-9478
Contract Pharmacy Representative
Coordinated Care Network
Thomas J Pollack, President/CEO
(412) 349-6300
Signed By Date
8/7/2020
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