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UNITED PHARMACY LLC
STD33069 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
STD33069
Entity Address
3167-69 West Atlantic Blvd
Pompano Beach, FL 33069
Grant Number
NH25PS004342
Participating Start Date
1/1/2020
Last Recertification Date
Entity Termination Date
7/1/2020
Pharmacy Details
Pharmacy Name
UNITED PHARMACY LLC
Pharmacy Address
3951 N. HAVERHILL ROAD #300
SUITE 120-121
WEST PALM BEACH, FL 33417
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
United Pharmacy
Andy Treiggs, Manager
(561) 632-7922
Signed By Date
10/14/2019
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