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CCN AMERICA, LP
RW400091E University of Florida
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Covered Entity Details
Entity Name
University of Florida
Subdivision Name
UF Health Women's Specialist-Jacksonville
Type
Ryan White Part D
340B ID
RW400091E
Entity Address
655 W. 8th Street 3rd Fl ACC Bldg.
Jacksonville, FL 32209
Grant Number
H12HA24824
Participating Start Date
10/1/2023
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
CCN AMERICA, LP
Pharmacy Address
COORDINATED CARE NETWORK PHARMACY
1500 W CYPRESS CREEK RD STE 203
FT LAUDERDALE, FL 33309
Pharmacy Comments
Contract Details
Approval Date
8/1/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tina M. Bottini, Senior Asst. Dean, Research
(904) 244-9478
Contract Pharmacy Representative
Coordinated Care Network
Thomas J Pollack, President/CEO
(412) 349-6300
Signed By Date
7/7/2023
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