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FLORIDA HLTH SCIENCES CTR INC
RW424835G University of South Florida Health Pediatric Infectious Diseases
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Covered Entity Details
Entity Name
University of South Florida Health Pediatric Infectious Diseases
Subdivision Name
Johns Hopkins All Children's Hospital Outpatient Care Center
Type
Ryan White Part D
340B ID
RW424835G
Entity Address
601 5th Street South
Suite 304
St Petersburg, FL 33701
Grant Number
H12HA24835
Participating Start Date
7/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
FLORIDA HLTH SCIENCES CTR INC
Pharmacy Address
TGH OUTPATIENT PHARMACY
5 TAMPA GENERAL CIR STE HMT -100
TAMPA, FL 33606-3601
Pharmacy Comments
Contract Details
Approval Date
4/14/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Patricia Emmanuel, Chair, Department of Pediatrics
(813) 259-8866
Contract Pharmacy Representative
Tampa General Hospital
Maja G. Gift, Pharmacy Administrator
(813) 844-4177
Signed By Date
4/14/2025
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