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PRIME THERAPEUTICS SPECIALTY PHARMACY LL
CH040210 CENTRAL FLORIDA HEALTH CARE, INC.
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Covered Entity Details
Entity Name
CENTRAL FLORIDA HEALTH CARE, INC.
Subdivision Name
CFHC Avon Park Primary Care
Type
HRSA-Funded Health Center
340B ID
CH040210
Entity Address
950 COUNTY ROAD 17-A, WEST
AVON PARK, FL 33825-2164
Grant Number
H80CS00423
Participating Start Date
1/1/2000
Last Recertification Date
2/10/2025
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
4/15/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/11/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
ANN CLAUSSEN, CEO
(863) 291-5115
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/15/2021
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