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ANGEL'S PHARMACY I INC
RWII34982 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
RWII34982
Entity Address
356 E MIDWAY RD
Fort Pierce, FL 34982
Grant Number
X07HA00057
Participating Start Date
1/1/2014
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
ANGEL'S PHARMACY I INC
Pharmacy Address
259 E MICHIGAN ST
ORLANDO, FL 32806
Pharmacy Comments
Contract Details
Approval Date
10/15/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kathryn E Hayden, CFO
(772) 742-9276
Contract Pharmacy Representative
Angel's Pharmacy I Inc.
Rajendra Patel, CEO
(407) 426-7000
Signed By Date
10/15/2021
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