340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ANGELS PHARMACY III LLC
STD32937 Doctor's Goodwill Foundation
Print
Covered Entity Details
Entity Name
Doctor's Goodwill Foundation
Subdivision Name
Omni - Indian Harbour Clinic
Type
Sexually Transmitted Diseases
340B ID
STD32937
Entity Address
2181 South Patrick Dr.
Indian Harbour Beach, FL 32937
Grant Number
5H25PS004342
Participating Start Date
1/1/2020
Last Recertification Date
Entity Termination Date
4/1/2020
Pharmacy Details
Pharmacy Name
ANGELS PHARMACY III LLC
Pharmacy Address
7455 S US HIGHWAY 1 STE A
TITUSVILLE, FL 32780
Pharmacy Comments
Contract Details
Approval Date
12/4/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Kantilal Bhalani, CEO
(321) 298-5531 Ext: 9414416212
Contract Pharmacy Representative
Angel's Pharmacy I Inc.
Rajendra Patel, CEO
(407) 426-7000
Signed By Date
10/14/2019
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session