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PHARMCO, LLC
RWII34982C Midway Specialty Care Center Inc
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Covered Entity Details
Entity Name
Midway Specialty Care Center Inc
Subdivision Name
Type
Ryan White Part B
340B ID
RWII34982C
Entity Address
5701 Overseas Highway
Ste # 10
Marathon, FL 33050
Grant Number
X07HA00057
Participating Start Date
4/1/2020
Last Recertification Date
2/8/2021
Entity Termination Date
10/1/2021
Pharmacy Details
Pharmacy Name
PHARMCO, LLC
Pharmacy Address
PHARMCO
400 ANSIN BLVD
STE A
HALLANDALE BEACH, FL 33009-3104
Pharmacy Comments
Contract Details
Approval Date
10/14/2020
Contract Begin Date
11/6/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Kathryn E Hayden, CFO
(772) 742-9276
Contract Pharmacy Representative
Pharmco
Shaun Nevel, Admin
(305) 760-2053
Signed By Date
10/14/2020
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