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ACARIAHEALTH PHARMACY #11, INC
CH040250 PROJECT HEALTH, INC.
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Covered Entity Details
Entity Name
PROJECT HEALTH, INC.
Subdivision Name
Langley Health Services Sumterville
Type
HRSA-Funded Health Center
340B ID
CH040250
Entity Address
1389 S Us 301
Sumterville, FL 33585-5143
Grant Number
H80CS00412
Participating Start Date
12/1/1992
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
ACARIAHEALTH PHARMACY #11, INC
Pharmacy Address
1311 W SAM HOUSTON PKWY N STE 130
HOUSTON, TX 77043-4015
Pharmacy Comments
Contract Details
Approval Date
10/13/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
John M. Sivon, Chief Strategy Officer
(352) 569-2386
Contract Pharmacy Representative
Acaria Health
Philip Gofman, Regional VP
(917) 312-5263
Signed By Date
10/13/2022
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