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AB SPECIALTY PHARMACY INC.
FQHCLA407J Metropolitan Charities, Inc.
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Covered Entity Details
Entity Name
Metropolitan Charities, Inc.
Subdivision Name
Metro Seminole Heights
Type
Health Center Program Look-Alike
340B ID
FQHCLA407J
Entity Address
3918 N Highland Ave
Tampa, FL 33603-4724
Grant Number
LALCS35348
Participating Start Date
12/21/2023
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
AB SPECIALTY PHARMACY INC.
Pharmacy Address
2311 SEVEN SPRINGS BLVD
NEW PORT RICHEY, FL 34655
Pharmacy Comments
Contract Details
Approval Date
12/28/2023
Contract Begin Date
12/28/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Priya Rajkumar, Chief Executive Officer
(727) 321-3854 Ext: 1230
Contract Pharmacy Representative
AB SPECIALTY PHARMACY INC
Bhupendra Patel, Pharmacy Manager
(727) 375-9520
Signed By Date
12/28/2023
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