Contract Pharmacy Details

CARE RESOURCE PHARMACY
RWIID32304 FLORIDA DEPARTMENT OF HEALTH

Covered Entity Details

Entity Name

FLORIDA DEPARTMENT OF HEALTH

Subdivision Name

AIDS Drug Assistance Program (ADAP)

Type

Ryan White Part B ADAP Direct Purchase

340B ID

RWIID32304

Entity Address

4052 BALD CYPRESS WAY
BIN A-09
TALLAHASSEE, FL 32399

Grant Number

X07HA00057

Participating Start Date

1/1/2009

Last Recertification Date

2/18/2025

Pharmacy Details

Pharmacy Name

CARE RESOURCE PHARMACY

Pharmacy Address

CARE RESOURCE COMMUNITY HEALTH CENTERS I
1431 ALTON RD
MIAMI BEACH, FL 33139

Pharmacy Comments

Contract Details

Approval Date

10/14/2024

Contract Begin Date

10/16/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

JIMMY ROGER LLAQUE, ADAP STATE PROGRAM DIRECTOR
(850) 545-6836

Contract Pharmacy Representative

Care Resource Community Health Centers, Inc
Keri Kratofil, Chief Executive Officer
(305) 576-1234 Ext: 157

Signed By Date

10/14/2024

340B Drug Pricing Program Database