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AVIVA CARE PHARMACY LLC
STD331271 New Horizons Community Mental Health Center, Inc.
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Covered Entity Details
Entity Name
New Horizons Community Mental Health Center, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD331271
Entity Address
43-45 NW 41st Street
Miami, FL 33127
Grant Number
5NU62PS924532-02
Participating Start Date
1/1/2020
Last Recertification Date
5/16/2022
Entity Termination Date
7/1/2023
Pharmacy Details
Pharmacy Name
AVIVA CARE PHARMACY LLC
Pharmacy Address
2053 N. UNIVERSITY DR.
SUNRISE, FL 33322-3936
Pharmacy Comments
Contract Details
Approval Date
11/26/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Jerry Rodriguez, Chief of Operations
(305) 506-5219
Contract Pharmacy Representative
Aviva Care Pharmcay
Berioska Soso, Vice President
(954) 451-5578
Signed By Date
10/2/2019
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