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PALMS HEALTH SERVICES LLC
STD336111 Midway Specialty Care Center
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Covered Entity Details
Entity Name
Midway Specialty Care Center
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD336111
Entity Address
3317 W Gandy Blvd
TAMPA, FL 33611
Grant Number
NH25PS005131
Participating Start Date
4/1/2018
Last Recertification Date
5/9/2023
Entity Termination Date
4/1/2024
Pharmacy Details
Pharmacy Name
PALMS HEALTH SERVICES LLC
Pharmacy Address
PALMS PHARMACY
3491 S CONGRESS AVE
PALM SPRINGS, FL 33461-3021
Pharmacy Comments
Contract Details
Approval Date
10/14/2020
Contract Begin Date
11/9/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/1/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Kathryn E Hayden, CFO
(772) 742-9276
Contract Pharmacy Representative
Palms Pharmacy
Anand Tripathi, Owner
(561) 513-9161
Signed By Date
10/14/2020
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