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GUARDIAN PHARMACY LLC
STD328251 Aum International Foundation, Inc.
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Covered Entity Details
Entity Name
Aum International Foundation, Inc.
Subdivision Name
GCCF
Type
Sexually Transmitted Diseases
340B ID
STD328251
Entity Address
10800 DYLAN LOREN CIRCLE
Suite 102
ORLANDO, FL 32825
Grant Number
5H25PS004342
Participating Start Date
4/1/2020
Last Recertification Date
5/7/2021
Entity Termination Date
10/1/2021
Pharmacy Details
Pharmacy Name
GUARDIAN PHARMACY LLC
Pharmacy Address
483 N SEMORAN BLVD STE 109
WINTER PARK, FL 32792-3800
Pharmacy Comments
Contract Details
Approval Date
2/24/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Ganesh Ramachandran, President
(407) 970-5253
Contract Pharmacy Representative
Guardian Pharmacy LLC
Siva Kondapalli, President
(407) 790-4509
Signed By Date
2/21/2020
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