Contract Pharmacy Details

FLORIDA A&M UNIVERSITY
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

FLORIDA A&M UNIVERSITY

Pharmacy Address

FAMU HEALTH DEPT PHARAMCY
872 W ORANGE AVE
TALLAHASSEE, FL 32310

Pharmacy Comments

Contract Details

Approval Date

4/17/2023

Contract Begin Date

7/1/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

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

Contract Pharmacy Representative

OPS Pharmacy LLC . DBA Butterfly Pharmacy
Chiranjivi Jannu, Director of Pharmacy
(646) 673-0044

Signed By Date

4/17/2023

340B Drug Pricing Program Database