Contract Pharmacy Details

CORAM HEALTHCARE CORPORATION OF SOUTHERN
CHC11399-00 Care Resource Community Health Centers, Inc.

Covered Entity Details

Entity Name

Care Resource Community Health Centers, Inc.

Subdivision Name

Care Resource Community Health Center at Ft. Lauderdale

Type

HRSA-Funded Health Center

340B ID

CHC11399-00

Entity Address

871 W Oakland Park Blvd
Wilton Manors, FL 33311-1731

Grant Number

H80CS12864

Participating Start Date

7/1/2009

Last Recertification Date

2/21/2025

Pharmacy Details

Pharmacy Name

CORAM HEALTHCARE CORPORATION OF SOUTHERN

Pharmacy Address

DBA CORAM CVS/SPECIALTY INFUSION SERVICE
12006 MIRAMAR PARKWAY
MIRAMAR, FL 33025-7005

Pharmacy Comments

Contract Details

Approval Date

4/12/2021

Contract Begin Date

7/1/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

8/28/2022
Pharmacy closed

Contacts

Covered Entity Signing Official

Rick Siclari, Chief Executive Officer
(305) 576-1234 Ext: 206

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

4/12/2021

340B Drug Pricing Program Database