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CRESCENT HEALTHCARE, INC.
RWII32117 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Daytona
Type
Ryan White Part B
340B ID
RWII32117
Entity Address
1125 N. Nova Rd.
Daytona Beach, FL 32117
Grant Number
X07HA00057
Participating Start Date
7/1/2014
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
CRESCENT HEALTHCARE, INC.
Pharmacy Address
5431 SW 35TH DR STE 200
GAINESVILLE, FL 32608
Pharmacy Comments
Contract Details
Approval Date
4/26/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard E. Carlisle, President & CEO
(941) 366-0461 Ext: 11111
Contract Pharmacy Representative
Option Care
Jon Adair, Vice President, Health System Solutions
(847) 830-9996
Signed By Date
4/26/2016
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