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PHARMCO, LLC
STD33403 Positive Health Alliance, Inc.
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Covered Entity Details
Entity Name
Positive Health Alliance, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33403
Entity Address
1511 Prosperity Farms Rd
Lake Park, FL 33403
Grant Number
NH25PS004342
Participating Start Date
1/1/2020
Last Recertification Date
Entity Termination Date
7/1/2020
Pharmacy Details
Pharmacy Name
PHARMCO, LLC
Pharmacy Address
PHARMCO
400 ANSIN BLVD
STE A
HALLANDALE BEACH, FL 33009-3104
Pharmacy Comments
Contract Details
Approval Date
11/20/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Gary G Kogan, Executive Director
(888) 752-2267
Contract Pharmacy Representative
Pharmco, LLC
Armen Karapetyan, General Manager
(305) 919-7399 Ext: 201
Signed By Date
10/14/2019
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