Contract Pharmacy Details

PUBLIX SUPER MARKETS
DSH100009 University of Miami Hospital

Covered Entity Details

Entity Name

University of Miami Hospital

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH100009

Entity Address

1400 N.W. 12th Ave
Miami, FL 33136

Medicare Provider Number

100009

Participating Start Date

4/1/2013

Last Recertification Date

8/31/2016

Entity Termination Date

1/1/2018

Pharmacy Details

Pharmacy Name

PUBLIX SUPER MARKETS

Pharmacy Address

PUBLIX PHARMACY #0621
1920 WEST AVE
MIAMI BEACH, FL 33139

Pharmacy Comments

Contract Details

Approval Date

10/13/2014

Contract Begin Date

1/1/2015

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2018
Covered Entity Terminated

Contacts

Covered Entity Signing Official

David Zambrana, Chief Executive Officer
(305) 689-4515

Contract Pharmacy Representative

University of Miami Hospital and Clinics
Blanca Rivera, Associate Vice President, UHealth Pharmacy Services
(305) 689-5630

Signed By Date

10/13/2014

340B Drug Pricing Program Database