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ACCARDI CLINICAL SERVICES
STD32127 Doctor's Goodwill Foundation Inc
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Covered Entity Details
Entity Name
Doctor's Goodwill Foundation Inc
Subdivision Name
Advanced Urgent Care
Type
Sexually Transmitted Diseases
340B ID
STD32127
Entity Address
1690 Dunlawton Ave
Ste 120
Port Orange, FL 32127
Grant Number
H25PS005131
Participating Start Date
4/1/2020
Last Recertification Date
5/3/2021
Entity Termination Date
10/1/2021
Pharmacy Details
Pharmacy Name
ACCARDI CLINICAL SERVICES
Pharmacy Address
2583 S VOLUSIA AVE STE 100
ORANGE CITY, FL 32763-9129
Pharmacy Comments
Contract Details
Approval Date
3/2/2020
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
Kantilal Bhalani, CEO
(321) 298-5531 Ext: 9414416212
Contract Pharmacy Representative
Accardi Clinical Services Inc DBA Accardi Clinical Pharmacy
John Roger Accardi, President
(386) 774-5800
Signed By Date
3/2/2020
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