340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
RXHEALTHCARE SYSTEM LLC
RWII32114 Outreach Community Care Network
Print
Covered Entity Details
Entity Name
Outreach Community Care Network
Subdivision Name
Type
Ryan White Part B
340B ID
RWII32114
Entity Address
240 N Frederick Avenue
Daytona Beach, FL 32114
Grant Number
XO7HA00057
Participating Start Date
4/1/2013
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
RXHEALTHCARE SYSTEM LLC
Pharmacy Address
DBA:COMMUNITY PHARMACY OF PORT ORANGE
3755 S NOVA RD STE A
PORT ORANGE, FL 32129
Pharmacy Comments
Contract Details
Approval Date
4/4/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Latreace Flynt, Clinical Director
(386) 235-1911 Ext: 216
Contract Pharmacy Representative
Pharmacy
Tejas Mehta, Pharmacy Manager
(386) 256-3177
Signed By Date
4/4/2023
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