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VOLEL PRFSNL PHRMST ASSOC
RW424835D University of South Florida, College of Public Health
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Covered Entity Details
Entity Name
University of South Florida, College of Public Health
Subdivision Name
Positively U
Type
Ryan White Part D
340B ID
RW424835D
Entity Address
1419 West Waters Avenue
Suite 117
Tampa, FL 33604
Grant Number
H12HA24835
Participating Start Date
7/1/2016
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
VOLEL PRFSNL PHRMST ASSOC
Pharmacy Address
PHARMACYONEPRO SPCLTY CR PHMCY
65 3RD ST NW
SUITE 59
WINTER HAVEN, FL 33881
Pharmacy Comments
Contract Details
Approval Date
4/15/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/24/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Janet Kitchen, Executive Director
(813) 857-2974
Contract Pharmacy Representative
Nota Consulting Group, LLC
Fungisai Nota, 340B Program Manager
(610) 742-7763
Signed By Date
4/15/2018
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