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KIDS HOME CARE, INC
HM33612 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, Tampa
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM33612
Entity Address
12220 Bruce B Downs Blvd.
Tampa, FL 33612
Grant Number
H30MC24046
Participating Start Date
7/1/2018
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
KIDS HOME CARE, INC
Pharmacy Address
JOHNS HOPKINS ALL CHILDREN'S HOME CARE,
550 9TH AVENUE SOUTH
ST PETERSBURG, FL 33701
Pharmacy Comments
Contract Details
Approval Date
5/18/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/30/2020
Pharmacy closed
Contacts
Covered Entity Signing Official
Roberta Alessi, VP & Chief Operating Officer
(727) 767-2868
Contract Pharmacy Representative
Kids Home Care, Inc.
Fani Lane, Registered Pharmacist
(727) 767-8212
Signed By Date
4/11/2018
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