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ANGEL'S PHARMACY I INC
RWII327921D Hope and Help Center of Central Florida, Inc.
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Covered Entity Details
Entity Name
Hope and Help Center of Central Florida, Inc.
Subdivision Name
Orlando Infectious Disease Center
Type
Ryan White Part B
340B ID
RWII327921D
Entity Address
4401 S. Orange Avenue
Suite 118
Orlando, FL 32806
Grant Number
X07HA00057
Participating Start Date
10/1/2017
Last Recertification Date
Entity Termination Date
4/1/2018
Pharmacy Details
Pharmacy Name
ANGEL'S PHARMACY I INC
Pharmacy Address
259 E MICHIGAN ST
ORLANDO, FL 32806
Pharmacy Comments
Contract Details
Approval Date
1/11/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Lisa Barr, Executive Director
(407) 645-2577 Ext: 121
Contract Pharmacy Representative
Angel's Pharmacy I Inc.
Rajendra Patel, CEO
(407) 426-7000
Signed By Date
1/11/2018
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