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EXPRESS SPECIALTY PHARMACY, LLC
STD32324 North Florida Rural Health Corp
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Covered Entity Details
Entity Name
North Florida Rural Health Corp
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD32324
Entity Address
680 Maple Street
Chattahoochee, FL 32324
Grant Number
NH25PS005131
Participating Start Date
7/1/2023
Last Recertification Date
5/11/2024
Pharmacy Details
Pharmacy Name
EXPRESS SPECIALTY PHARMACY, LLC
Pharmacy Address
EXPRESS SPECIALTY PHARMACY LLC
7303 N NEBRASKA AVE
TAMPA, FL 33604
Pharmacy Comments
Contract Details
Approval Date
10/11/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Walter Kyles, Executive Director
(850) 999-3181
Contract Pharmacy Representative
EXPRESS SPECIALTY PHARMACY
OSAMA AL-NAJJAR, PHARMACIST
(813) 288-0888
Signed By Date
10/11/2024
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