Contract Pharmacy Details

OPTION CARE ENTERPRISES, INC.
RWII33614 CAN Community Health, Inc.

Covered Entity Details

Entity Name

CAN Community Health, Inc.

Subdivision Name

Type

Ryan White Part B

340B ID

RWII33614

Entity Address

6919 N. Dale Mabry
Suite 300
Tampa, FL 33614

Grant Number

X07HA00057

Participating Start Date

1/1/2015

Last Recertification Date

2/20/2018

Entity Termination Date

1/1/2019

Pharmacy Details

Pharmacy Name

OPTION CARE ENTERPRISES, INC.

Pharmacy Address

DBA OPTION CARE
11650 MIRAMAR PARKWAY
SUITE 100
MIRAMAR, FL 33025-5823

Pharmacy Comments

Contract Details

Approval Date

4/25/2016

Contract Begin Date

7/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2019
Covered Entity Terminated

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

4/25/2016

340B Drug Pricing Program Database