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PRX INCORPORATED
CH042400 CAMILLUS HEALTH CONCERN INC
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Covered Entity Details
Entity Name
CAMILLUS HEALTH CONCERN INC
Subdivision Name
CAMILLUS HEALTH CONCERN, INC.
Type
HRSA-Funded Health Center
340B ID
CH042400
Entity Address
336 NW 5th St
Miami, FL 33128-1616
Grant Number
H80CS00026
Participating Start Date
7/1/1995
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
PRX INCORPORATED
Pharmacy Address
PRX PHARMACY
5040 NW 7TH ST SUITE 470
MIAMI, FL 33126
Pharmacy Comments
Contract Details
Approval Date
4/2/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/12/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Francis Afram-Gyening, CEO
(216) 924-0385
Contract Pharmacy Representative
Independent Medical Group, LLC
Steve Vixamar, COO
(954) 529-1178
Signed By Date
4/2/2018
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