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PRIDE PHARMACY, LLC
STD33334 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Oakland Park
Type
Sexually Transmitted Diseases
340B ID
STD33334
Entity Address
1421 E Oakland Park Blvd
Suite 200
Fort Lauderdale, FL 33334
Grant Number
1 NH25PS005131-01-00
Participating Start Date
7/1/2017
Last Recertification Date
5/27/2024
Pharmacy Details
Pharmacy Name
PRIDE PHARMACY, LLC
Pharmacy Address
MIDLAND PHARMACY
1421 E OAKLAND PARK BLVD
STE 100
OAKLAND PARK, FL 33334
Pharmacy Comments
Contract Details
Approval Date
5/5/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/28/2025
Ownership change
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Midland Medical
Michael Supino, Managing Partner
(479) 366-7893
Signed By Date
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