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TAMPA FAMILY PHARMACY
RW424835A Metropolitan Charities, Inc.
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Covered Entity Details
Entity Name
Metropolitan Charities, Inc.
Subdivision Name
Type
Ryan White Part D
340B ID
RW424835A
Entity Address
1315 E. 7th Avenue
Suite 201
Tampa, FL 33605
Grant Number
H12HA24835
Participating Start Date
1/1/2016
Last Recertification Date
2/6/2020
Entity Termination Date
4/1/2021
Pharmacy Details
Pharmacy Name
TAMPA FAMILY PHARMACY
Pharmacy Address
12470 TELECOM DR STE 110W
TEMPLE TERRACE, FL 33637
Pharmacy Comments
Contract Details
Approval Date
4/13/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/21/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Lorraine Langlois, Chief Executive Officer
(727) 321-3854
Contract Pharmacy Representative
Tampa Family Pharmacy
Haley Miller, President
(813) 871-5161
Signed By Date
4/13/2016
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