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BELLE GLADE DRUGS LLC
STD334831 Treatment Outreach Program, Inc.
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Covered Entity Details
Entity Name
Treatment Outreach Program, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD334831
Entity Address
100 E Linton Blvd.
504B & 503A
Delray Beach, FL 33483
Grant Number
NH25PS004342
Participating Start Date
1/1/2018
Last Recertification Date
5/6/2024
Pharmacy Details
Pharmacy Name
BELLE GLADE DRUGS LLC
Pharmacy Address
K & M DRUGS
624 S MAIN ST STE 1
BELLE GLADE, FL 33430
Pharmacy Comments
Contract Details
Approval Date
10/15/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/3/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Demora Smith, Director
(561) 265-5306
Contract Pharmacy Representative
Belle Glade Drugs, LLC.
Kasem Kaki, Pharmacy Manager
(561) 996-0228
Signed By Date
10/15/2019
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