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PROPRIUM PHARMACY
STD333051 Midway Specialty Care Center
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Covered Entity Details
Entity Name
Midway Specialty Care Center
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD333051
Entity Address
2608 NE 16th Avenue
WILTON MANORS, FL 33334
Grant Number
NH25PS005131
Participating Start Date
4/1/2018
Last Recertification Date
5/12/2025
Pharmacy Details
Pharmacy Name
PROPRIUM PHARMACY
Pharmacy Address
535 INDEPENDENCE PKWY STE 400
CHESAPEAKE, VA 23320-5176
Pharmacy Comments
Contract Details
Approval Date
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kathryn E Hayden, CFO
(772) 742-9276
Contract Pharmacy Representative
Proprium Pharmacy
Jeremy Spires, Pharmacy Operations Manager
(757) 553-3514
Signed By Date
7/15/2024
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