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TAMPA FAMILY PHARMACY
STD325471 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Emerald Coast
Type
Sexually Transmitted Diseases
340B ID
STD325471
Entity Address
917 Mar Walt Drive
Fort Walton Beach, FL 32547
Grant Number
1 NH25PS005131-01-00
Participating Start Date
4/1/2022
Last Recertification Date
5/28/2025
Pharmacy Details
Pharmacy Name
TAMPA FAMILY PHARMACY
Pharmacy Address
12470 TELECOM DR STE 110W
TEMPLE TERRACE, FL 33637
Pharmacy Comments
Contract Details
Approval Date
2/11/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/28/2025
Ownership change
Contacts
Covered Entity Signing Official
Rishi Patel, President & CEO
(941) 300-4440 Ext: 11127
Contract Pharmacy Representative
TFP Wellness Systems
Haley Miller, President
(813) 871-5161
Signed By Date
1/19/2022
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