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CCN AMERICA, LP
CH040320 COMMUNITY HEALTH OF SOUTH FL, INC
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Covered Entity Details
Entity Name
COMMUNITY HEALTH OF SOUTH FL, INC
Subdivision Name
DORIS ISON COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH040320
Entity Address
10300 S.W. 216TH ST.
MIAMI, FL 33190
Grant Number
H80CS00821
Participating Start Date
12/1/1992
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
CCN AMERICA, LP
Pharmacy Address
COORDINATED CARE NETWORK PHARMACY
1500 W CYPRESS CREEK RD STE 203
FT LAUDERDALE, FL 33309
Pharmacy Comments
Contract Details
Approval Date
10/16/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brodes H. Hartley, President CEO
(305) 252-4853
Contract Pharmacy Representative
CCN AMERICA LP
Thomas J. Pollack, Vice President and CFO
(412) 349-6303
Signed By Date
10/16/2017
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