Contract Pharmacy Details

BAYCARE HOME CARE INC
RW424835B St Josephs Hospital

Covered Entity Details

Entity Name

St Josephs Hospital

Subdivision Name

Pinellas Care Clinic

Type

Ryan White Part D

340B ID

RW424835B

Entity Address

1201 5th Ave N
Suite 409
St. Petersburg, FL 33705

Grant Number

H12HA24835

Participating Start Date

7/1/2016

Last Recertification Date

2/26/2025

Pharmacy Details

Pharmacy Name

BAYCARE HOME CARE INC

Pharmacy Address

8452 118TH AVE N
LARGO, FL 33773-5007

Pharmacy Comments

Contract Details

Approval Date

4/23/2024

Contract Begin Date

7/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Carl Tremonti, Chief Financial Officer
(813) 870-4020

Contract Pharmacy Representative

BayCare HomeCare Inc
Noriko Kay, Director, Pharmacy - Home Care
(727) 395-2049

Signed By Date

4/23/2024

340B Drug Pricing Program Database