Contract Pharmacy Details

CARE RESOURCE PHARMACY
RWIID32304 FLORIDA DEPARTMENT OF HEALTH

Covered Entity Details

Entity Name

FLORIDA DEPARTMENT OF HEALTH

Subdivision Name

AIDS Drug Assistance Program (ADAP)

Type

Ryan White Part B ADAP Direct Purchase

340B ID

RWIID32304

Entity Address

4052 BALD CYPRESS WAY
BIN A-09
TALLAHASSEE, FL 32399

Grant Number

X07HA00057

Participating Start Date

1/1/2009

Last Recertification Date

2/18/2025

Pharmacy Details

Pharmacy Name

CARE RESOURCE PHARMACY

Pharmacy Address

CARE RESOURCE COMMUNITY HEALTH CENTERS I
1431 ALTON RD
MIAMI BEACH, FL 33139

Pharmacy Comments

Contract Details

Approval Date

7/7/2022

Contract Begin Date

10/1/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

3/1/2023
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

JIMMY ROGER LLAQUE, ADAP STATE PROGRAM DIRECTOR
(850) 545-6836

Contract Pharmacy Representative

CHC11399
Rick Siclari, Chief Executive Officer
(305) 576-1234 Ext: 206

Signed By Date

7/7/2022

340B Drug Pricing Program Database