340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
APAA LLC
CH04040B Southside Medical Center, Inc.
Print
Covered Entity Details
Entity Name
Southside Medical Center, Inc.
Subdivision Name
SOUTHSIDE MEDICAL CENTER - Riverdale Clinic
Type
HRSA-Funded Health Center
340B ID
CH04040B
Entity Address
116 Upper Riverdale Road SW
Riverdale, GA 30274-2556
Grant Number
H80CS00576
Participating Start Date
4/1/2010
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
APAA LLC
Pharmacy Address
D/B/A HOLIDAY PHARMACY
6815 N. DALE MABRY HIGHWAY
TAMPA, FL 33614
Pharmacy Comments
Contract Details
Approval Date
7/15/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
DAVID M. WILLIAMS, CEO
(404) 688-1350
Contract Pharmacy Representative
Brian Martin, Pharmacy Manager
(813) 956-0292
Signed By Date
7/15/2013
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session