340B Drug Pricing Program Database

Pharmacy Name

CORAM ALTERNATE SITE SERVICES, INC.

Pharmacy Address

DBA CORAM CVS/SPECIALTY INFUSION SERVICE
3439 NORTH 12TH AVENUE
SUITE A AND B
PENSACOLA, FL 32503-4008

Pharmacy Comments

Approval Date

7/17/2017

Contract Begin Date

10/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/17/2025
Business decision by covered entity and/or pharmacy

Covered Entity Signing Official

Andrew L. Terry, Vice President Revenue Management
(850) 469-7643

Contract Pharmacy Representative

Rhonda Sullivan, Branch Manager
(850) 469-4573

Signed By Date

7/17/2017