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FLORIDA HOSPITAL HOME INFUSION, LLP
DSH100007 AdventHealth Orlando
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Covered Entity Details
Entity Name
AdventHealth Orlando
Subdivision Name
Florida Hospital Orlando
Type
Disproportionate Share Hospital
340B ID
DSH100007
Entity Address
601 E. Rollins St.
Orlando, FL 32803-1248
Medicare Provider Number
100007
Participating Start Date
4/1/2012
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
FLORIDA HOSPITAL HOME INFUSION, LLP
Pharmacy Address
DBA- ADVENTHEALTH HOME INFUSION CENTRAL
556 FLORIDA CENTRAL PKWY STE 1044
LONGWOOD, FL 32750
Pharmacy Comments
Contract Details
Approval Date
1/11/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Daniel Myers, Senior Vice President Finance
(407) 303-5501
Contract Pharmacy Representative
Florida Hospital Home Infusion, LLP
Sheryl Raley, General Manager
(407) 865-5489 Ext: 2501
Signed By Date
1/11/2018
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