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HM BLOOMINGDALE LLC
STD337721 Advanced Bay Area Medical Associates
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Covered Entity Details
Entity Name
Advanced Bay Area Medical Associates
Subdivision Name
Seminole Office
Type
Sexually Transmitted Diseases
340B ID
STD337721
Entity Address
8207 113th Street
Seminole, FL 33772
Grant Number
NH25PS005131
Participating Start Date
8/31/2020
Last Recertification Date
5/7/2024
Pharmacy Details
Pharmacy Name
HM BLOOMINGDALE LLC
Pharmacy Address
DBA: BELL PHARMACY 001
3535 CENTRAL AVE
SAINT PETERSBURG, FL 33713
Pharmacy Comments
Contract Details
Approval Date
4/8/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jeffrey R Levenson, President
(727) 384-2479
Contract Pharmacy Representative
Bell Pharmacy
Anthony Pasquale Trunzo, Mananger
(813) 689-2273
Signed By Date
4/8/2024
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