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DEPARTMENT OF HEALTH
RWIID32304 FLORIDA DEPARTMENT OF HEALTH
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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
DEPARTMENT OF HEALTH
Pharmacy Address
DEPARTMENT PHARMACY
1105 E KENNEDY BLVD
ANNEX BUILDING
TAMPA, FL 33602
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
Hillsborough County Health Department
Douglas A Holt, County Health Department Director
(813) 559-4323
Signed By Date
4/17/2023
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