Contract Pharmacy Details

CAN COMMUNITY HEALTH, INC.
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

CAN COMMUNITY HEALTH, INC.

Pharmacy Address

CAN COMMUNITY HEALTH PHARMACY OF CLEARWA
2349 SUNSET POINT RD STE 404
CLEARWATER, FL 33765

Pharmacy Comments

Contract Details

Approval Date

10/15/2022

Contract Begin Date

1/1/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

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

Contract Pharmacy Representative

CAN Community Health Inc.
Ryan Atkinson, Sr. Director of Payor Contracting
(806) 242-7782

Signed By Date

10/15/2022

340B Drug Pricing Program Database