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VISTA MEDICAL GROUP LLC
STD33544 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Wesley Chapel
Type
Sexually Transmitted Diseases
340B ID
STD33544
Entity Address
5504 Gateway Blvd
Wesley Chapel, FL 33544
Grant Number
1 NH25PS005131-01-00
Participating Start Date
4/1/2016
Last Recertification Date
6/3/2025
Pharmacy Details
Pharmacy Name
VISTA MEDICAL GROUP LLC
Pharmacy Address
MEDICASCRIPTS PHARMACY
15511 N. FLORIDA AVE
TAMPA, FL 33613
Pharmacy Comments
Contract Details
Approval Date
7/14/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/13/2018
Ownership change
Contacts
Covered Entity Signing Official
Richard E. Carlisle, President & CEO
(941) 366-0461 Ext: 11111
Contract Pharmacy Representative
Bhavik Patel, owner
(813) 968-0520
Signed By Date
7/14/2016
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