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HM BLOOMINGDALE LLC
STD331811 Akeso Community Health
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Covered Entity Details
Entity Name
Akeso Community Health
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD331811
Entity Address
1801 NE 123rd St.
Ste 417
North Miami, FL 33181
Grant Number
NU62PS924532
Participating Start Date
1/1/2024
Last Recertification Date
5/13/2024
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
7/2/2024
Contract Begin Date
9/4/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
William Matias, Executive Officer
(786) 534-4907
Contract Pharmacy Representative
Bell Pharmacy
Anthony Pasquale Trunzo, Mananger
(813) 689-2273
Signed By Date
7/2/2024
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