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ACARIAHEALTH PHARMACY #26, INC
CAN100079-00 UNIVERSITY OF MIAMI HOSPITAL AND CLINICS
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Covered Entity Details
Entity Name
UNIVERSITY OF MIAMI HOSPITAL AND CLINICS
Subdivision Name
Type
Free Standing Cancer Hospital
340B ID
CAN100079-00
Entity Address
1475 NW 12th Avenue
2080A
Miami, FL 33136
Medicare Provider Number
100079
Participating Start Date
1/1/2011
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
ACARIAHEALTH PHARMACY #26, INC
Pharmacy Address
8715 HENDERSON RD
TAMPA, FL 33634
Pharmacy Comments
Contract Details
Approval Date
7/14/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Kymberlee Manni, CEO
(305) 689-4515
Contract Pharmacy Representative
Acaria Health
Philip Gofman, Regional VP
(917) 312-5263
Signed By Date
7/14/2021
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