Covered Entity Details

STD331611 Flex 4 Medical Center Corp (Terminated) - information as of 4/25/2025 12:01:37 AM

Main Details

Name

Flex 4 Medical Center Corp

Subdivision Name

Type

Sexually Transmitted Diseases

340B ID

STD331611

Grant Number

NH25PS005131

Nature of Support
Please Describe the “in-kind” Support
Time period section 318 funding or in-kind support was received

In-Kind products or services (see note below; must have been purchased with section 318 funds)
Note: In-kind contributions may be in the form of real property, equipment, supplies and other expendable property, and goods and services directly benefiting and specifically identifiable to the project or program.
FLORIDA DEPARTMENT OF HEALTH STD HIV/STD TESTING KITS
10/1/2021 - 10/1/2022

Additional Details

Current Program Status

Terminated

Registration Date

10/15/2021

Participating Start Date

1/1/2022

Participating Approval Date

11/22/2021

Last Recertification Date

6/5/2022

Notice of Funding Opportunity (NOFO) Number

PS19-1901

Termination Date
Termination Reason

7/1/2023
Failure to recertify

Contacts

Authorizing Official

FLEX 4 MEDICAL CENTER CORP.
TRENISE BENNETT, EXECUTIVE DIRECTOR
(561) 560-7373

Primary Contact

FLEX 4 MEDICAL CENTER CORP.
Renal Roberty, President
(561) 560-7373

Addresses

Street Address

900 NE 125 ST
STE 200
NORTH MIAMI, FL 33161

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	ICARE RX LLC	14447 COUNTRY WALK DR		MIAMI	FL	33186	11/22/2021	01/01/2022	07/01/2023	07/01/2023
Contract Detail	PHARMCO, LLC	PHARMCO	400 ANSIN BLVD STE A	HALLANDALE BEACH	FL	33009-3104	11/22/2021	01/01/2022	07/01/2023	07/01/2023
Contract Detail	PHYSICIAN'S RX PHARMACY, LLC	PHYSICIANS RX PHARMACY, LLC	9701 APOLLO DRIVE #400	LARGO	MD	20774	01/15/2022	04/01/2022	07/01/2023	07/01/2023
Contract Detail	PRESCRIPTION DRUG FOUNDATION	NORTH MIAMI BEACH INC	1777 NE 163RD ST	NORTH MIAMI BEACH	FL	33162	11/22/2021	01/01/2022	07/01/2023	07/01/2023
Contract Detail	PRXP OF CA LLC	PRXP OF CA LLC	4345 E LOWELL ST STE C & D	ONTARIO	CA	91761	01/15/2022	04/01/2022	07/01/2023	07/01/2023
Contract Detail	PRXP OF NEW YORK LLC	DBA BROADWAY FAMILY PHARMACY	601 AMSTERDAM AVE	NEW YORK	NY	10024	01/15/2022	04/01/2022	07/01/2023	07/01/2023
Contract Detail	TOUCHPOINT RX, LLC	DBA PHARMCO RX 1002, LLC	3208 2ND AVE N STE 4	PALM SPRINGS	FL	33461-3682	11/22/2021	01/01/2022	07/01/2023	07/01/2023

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	7/1/2023 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Recertification		6/30/2023 12:00:00 AM	6/14/2023 11:04 AM
Details	State	Update	Recertification	Active	To Be Terminated	6/14/2023 11:04 AM
Terminations	Termination Date	Update	Recertification		7/1/2023 12:00:00 AM	6/14/2023 11:04 AM
Terminations	Termination Effective Date	Update	Recertification		7/1/2023 12:00:00 AM	6/14/2023 11:04 AM
Terminations	Termination Reason	Update	Recertification		Failure to recertify	6/14/2023 11:04 AM
Details	Last Recertification Date	Update	Recertification		6/5/2022 8:48:50 PM	6/5/2022 8:48 PM
Details	State	Update		Approved	Active	1/1/2022 12:01 AM
Contacts	Signed By	Insert	New Registration		BENNETT, TRENISE EXECUTIVE DIRECTOR FLEX 4 MEDICAL CENTER CORP. 5615607373	11/22/2021 2:05 PM
Details	340B ID	Update	New Registration		STD331611	11/22/2021 2:05 PM
Dates	Participating Approval Date	Update	New Registration		11/22/2021 2:05:26 PM	11/22/2021 2:05 PM
Details	State	Update	New Registration	Pending	Approved	11/22/2021 2:05 PM
Dates	Signed By Date	Update	New Registration		10/15/2021 9:32:09 PM	11/22/2021 2:05 PM
Dates	Start Date	Update	New Registration		1/1/2022 12:00:00 AM	11/22/2021 2:05 PM
Addresses	Main Address	Insert	New Registration		900 NE 125 ST STE 200 NORTH MIAMI, FL 33161	10/15/2021 9:32 PM
Details	Nature of Support: In Kind Support Description	Insert	New Registration		FLORIDA DEPARTMENT OF HEALTH STD HIV/STD TESTING KITS	10/15/2021 9:32 PM
Details	Nature Of Support	Insert	New Registration		In-Kind products or services (see note below; must have been purchased with section 318 funds)	10/15/2021 9:32 PM
Details	Nature of Support: Support Received From Date	Insert	New Registration		10/1/2021 12:00:00 AM	10/15/2021 9:32 PM
Details	Nature of Support: Support Received To Date	Insert	New Registration		10/1/2022 12:00:00 AM	10/15/2021 9:32 PM
Contacts	Primary Contact	Insert	New Registration		Roberty, Renal President FLEX 4 MEDICAL CENTER CORP. 5615607373	10/15/2021 9:32 PM
Contacts	Authorizing Official	Insert	New Registration		BENNETT, TRENISE EXECUTIVE DIRECTOR FLEX 4 MEDICAL CENTER CORP. 5615607373	10/15/2021 9:32 PM
Details	Assistance Received From Date	Insert	New Registration			10/15/2021 9:32 PM
Details	Assistance Received To Date	Insert	New Registration			10/15/2021 9:32 PM
Details	Last Recertification Date	Insert	New Registration			10/15/2021 9:32 PM
Details	Grant Number	Insert	New Registration		NH25PS005131	10/15/2021 9:32 PM
Details	340B ID	Insert	New Registration			10/15/2021 9:32 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			10/15/2021 9:32 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			10/15/2021 9:32 PM
Details	Medicare Provider Number	Insert	New Registration			10/15/2021 9:32 PM
Details	Entity Name	Insert	New Registration		Flex 4 Medical Center Corp	10/15/2021 9:32 PM
Details	NOFO Number	Insert	New Registration		PS19-1901	10/15/2021 9:32 PM
Details	Program Code	Insert	New Registration		STD	10/15/2021 9:32 PM
Details	Entity Subname	Insert	New Registration			10/15/2021 9:32 PM
Dates	Participating Approval Date	Insert	New Registration			10/15/2021 9:32 PM
Details	State	Insert	New Registration		Pending	10/15/2021 9:32 PM
Dates	Registration Date	Insert	New Registration		10/15/2021 9:32:06 PM	10/15/2021 9:32 PM
Dates	Signed By Date	Insert	New Registration			10/15/2021 9:32 PM
Dates	Start Date	Insert	New Registration			10/15/2021 9:32 PM
Terminations	Termination Comments	Insert	New Registration			10/15/2021 9:32 PM
Terminations	Termination Date	Insert	New Registration			10/15/2021 9:32 PM
Terminations	Termination Effective Date	Insert	New Registration			10/15/2021 9:32 PM
Terminations	Termination Reason	Insert	New Registration			10/15/2021 9:32 PM

340B Drug Pricing Program Database

Comments

Medicaid Billing

Shipping Addresses

Contract Pharmacies

History