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SKYEMED PHARMACY & INFUSION SERVICE
DSH100009 University of Miami Hospital
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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
SKYEMED PHARMACY & INFUSION SERVICE
Pharmacy Address
SKYEMED PHARMACY & INFUSION SVCS
1332 NORTH FEDERAL HWY
POMPANO BEACH, FL 33062
Pharmacy Comments
Contract Details
Approval Date
7/15/2015
Contract Begin Date
10/1/2015
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
Ravikumar Baskaran, Controller
(866) 778-8255 Ext: 219
Signed By Date
7/15/2015
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