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PHARMACY CARE
STD333051 Midway Specialty Care Center
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Covered Entity Details
Entity Name
Midway Specialty Care Center
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD333051
Entity Address
2608 NE 16th Avenue
WILTON MANORS, FL 33334
Grant Number
NH25PS005131
Participating Start Date
4/1/2018
Last Recertification Date
5/12/2025
Pharmacy Details
Pharmacy Name
PHARMACY CARE
Pharmacy Address
DBA: THE MEDICINE SHOPPE
1905 N ANDREWS AVE
WILTON MANORS, FL 33311-3914
Pharmacy Comments
Contract Details
Approval Date
1/23/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/1/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Moti Ramgopal, CEO
(772) 464-9746
Contract Pharmacy Representative
PHARMACY CARE
LYNN WILLIAMS, OWNER
(954) 563-8407
Signed By Date
1/11/2018
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