340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CCN AMERICA, LP
STD349501 In the Image of Christ
Print
Covered Entity Details
Entity Name
In the Image of Christ
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD349501
Entity Address
707 North 7th St.
Fort Pierce, FL 34950
Grant Number
NH25PS005131
Participating Start Date
4/1/2021
Last Recertification Date
5/9/2024
Pharmacy Details
Pharmacy Name
CCN AMERICA, LP
Pharmacy Address
COORDINATED CARE NETWORK PHARMACY
1500 W CYPRESS CREEK RD STE 203
FT LAUDERDALE, FL 33309
Pharmacy Comments
Contract Details
Approval Date
10/13/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Hazel Hoylman, Executive Director
(772) 461-7788 Ext: 109
Contract Pharmacy Representative
Coordinated Care Network
Thomas J Pollack, President/CEO
(412) 349-6300
Signed By Date
10/13/2022
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session