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ACCARDI CLINICAL SERVICES
STD321271 Doctor's Goodwill Foundation Inc
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Covered Entity Details
Entity Name
Doctor's Goodwill Foundation Inc
Subdivision Name
Advanced Gastroenterology & Endoscopy Centers
Type
Sexually Transmitted Diseases
340B ID
STD321271
Entity Address
1690 Dunlawton Ave
Ste 210
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
3/5/2020
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
3/5/2020
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