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MAHANT RX INC
CHC26626-00 FOUNDCARE INC.
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Covered Entity Details
Entity Name
FOUNDCARE INC.
Subdivision Name
FoundCare Health Center
Type
HRSA-Funded Health Center
340B ID
CHC26626-00
Entity Address
2330 S. Congress Avenue
West Palm Beach, FL 33406-7608
Grant Number
H80CS26626
Participating Start Date
4/1/2014
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
MAHANT RX INC
Pharmacy Address
DBA BELLE GLADE PHARMACY
136 S MAIN ST STE B
BELLE GLADE, FL 33430-3424
Pharmacy Comments
Contract Details
Approval Date
1/15/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rik Pavlescak, Chief Administrative Officer
(561) 432-7902
Contract Pharmacy Representative
Robalo Pharmacy
Nirav Patel, Vice President
(561) 844-1191
Signed By Date
1/15/2019
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