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SUNRISE PHARMACY OF KISSIMMEE LLC
STD33880 University of South Florida
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Covered Entity Details
Entity Name
University of South Florida
Subdivision Name
Positively U, Inc.
Type
Sexually Transmitted Diseases
340B ID
STD33880
Entity Address
320 1st Street South
Winter Haven, FL 33880
Grant Number
5H25PS004342
Participating Start Date
7/1/2018
Last Recertification Date
5/20/2024
Pharmacy Details
Pharmacy Name
SUNRISE PHARMACY OF KISSIMMEE LLC
Pharmacy Address
SUNRISE PHARMACY
4543 PLEASANT HILL RD STE D
KISSIMMEE, FL 34759-3406
Pharmacy Comments
Contract Details
Approval Date
10/2/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/12/2021
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
10/2/2019
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