Contract Pharmacy Details

RX-MART PHARMACY
STD34787 26Health, Inc.

Covered Entity Details

Entity Name

26Health, Inc.

Subdivision Name

West Orange Nephrology, LLC

Type

Sexually Transmitted Diseases

340B ID

STD34787

Entity Address

1210 E. Plant St.
120
Winter Garden, FL 34787

Grant Number

1H25PS004342-02

Participating Start Date

1/1/2024

Last Recertification Date

Entity Termination Date

7/1/2024

Pharmacy Details

Pharmacy Name

RX-MART PHARMACY

Pharmacy Address

RX MART PHARMACY
665 STATE ROAD 207
STE 101
SAINT AUGUSTINE, FL 32084

Pharmacy Comments

Contract Details

Approval Date

10/14/2019

Contract Begin Date

1/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2022
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

David Baker-Hargrove, President/Co-CEO
(321) 800-2922

Contract Pharmacy Representative

rx-mart pharmacy
Nagesh Shakamoori, president
(904) 342-2162

Signed By Date

10/14/2019

340B Drug Pricing Program Database