Contract Pharmacy Details

HEDGES PRESCRIPTION SHOP INC
RWII342371D CAN Community Health, Inc.

Covered Entity Details

Entity Name

CAN Community Health, Inc.

Subdivision Name

Clearwater

Type

Ryan White Part B

340B ID

RWII342371D

Entity Address

2349 Sunset Point Rd.
Suite 404
Clearwater, FL 33765

Grant Number

X07HA00057

Participating Start Date

7/1/2016

Last Recertification Date

2/25/2022

Entity Termination Date

10/1/2022

Pharmacy Details

Pharmacy Name

HEDGES PRESCRIPTION SHOP INC

Pharmacy Address

HEDGES PRESCRIPTION SHOP INC
24 N LIME AVE
SARASOTA, FL 34237-6120

Pharmacy Comments

Contract Details

Approval Date

10/16/2017

Contract Begin Date

1/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/1/2022
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Richard E. Carlisle, President & CEO
(941) 366-0461 Ext: 11111

Contract Pharmacy Representative

Hedges Prescription Shop
Chris Mottram, President & CEO
(941) 366-2424

Signed By Date

10/16/2017

340B Drug Pricing Program Database