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HEMOPHILIA OF GEORGIA
HM33805 JOHNS HOPKINS ALL CHILDREN'S HOSPITAL, INC.
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Covered Entity Details
Entity Name
JOHNS HOPKINS ALL CHILDREN'S HOSPITAL, INC.
Subdivision Name
Johns Hopkins All Children's Outpatient Care, Lakeland
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM33805
Entity Address
3310 Lakeland Hills Blvd.
Lakeland, FL 33805
Grant Number
H30MC24046
Participating Start Date
7/1/2018
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
HEMOPHILIA OF GEORGIA
Pharmacy Address
HEMOPHILIA OF GEORGIA
8607 ROBERTS DR STE 150A
SANDY SPRINGS, GA 30350-2238
Pharmacy Comments
Contract Details
Approval Date
4/23/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/27/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Roberta Alessi, VP & Chief Operating Officer
(727) 767-2868
Contract Pharmacy Representative
Hemophilia of Georgia
Edith A Rosato, CEO
(770) 518-8272
Signed By Date
4/11/2018
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