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ESI MAIL PHARMACY SERVICE
STD335441 West Central Gastroenterology dba Gastro Florida
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Covered Entity Details
Entity Name
West Central Gastroenterology dba Gastro Florida
Subdivision Name
Gastro Florida Division 19
Type
Sexually Transmitted Diseases
340B ID
STD335441
Entity Address
3821 Maryweather Ln
Unit 101
Wesley Chapel, FL 33544
Grant Number
H25PS005131
Participating Start Date
10/1/2022
Last Recertification Date
5/23/2024
Pharmacy Details
Pharmacy Name
ESI MAIL PHARMACY SERVICE
Pharmacy Address
DBA EXPRESS SCRIPTS
7909 S HARDY DR STE 106
TEMPE, AZ 85284-1112
Pharmacy Comments
Contract Details
Approval Date
8/12/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Seena Salyani, CEO
(727) 347-0536
Contract Pharmacy Representative
Express Scripts
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
7/14/2022
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