Attached files
Exhibit 10.4
AHCA CONTRACT NO. FA972
MINOR MODIFICATION NO. 2
WELLCARE OF FLORIDA, INC.
D/B/A HEALTHEASE
8735 Henderson Road
Renaissance 2
Tampa, Florida 33634
AHCA Contract No. FA972, as entered into on the 30th day of August 2012, is hereby revised as follows:
1. | Standard Contract, Section III, Item B., Contract Managers, sub-item 1, is hereby amended to now read as follows: |
1. | The Agency’s Contract Manager’s contact information is as follows: |
Tanya Hand
Agency for Health Care Administration
2727 Mahan Drive, MS #50
Tallahassee, FL 32308
(850) 412-4060
All other terms and conditions of the Contract shall remain unchanged.
WELLCARE OF FLORIDA, INC. | STATE OF FLORIDA, AGENCY FOR | |||
D/B/A HEALTHEASE | HEALTH CARE ADMINISTRATION | |||
/s/ Gregg MacDonald | /s/ Tanya Hand | |||
Gregg MacDonald | Tanya Hand | |||
State President | Contract Manager | |||
DATE: | 4-8-14 | DATE: | 4/9/14 | |
APPROVED | ||||
/s/ David Rogers | ||||
David Rogers | ||||
Assistant Deputy Secretary for Medicaid | ||||
Health Systems | ||||
DATE: | 4/9/14 | |||
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
AHCA Contract No. FA972, Minor Modification No. 2, Page 1 of 1