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PHARMCO, LLC
STD322021 Positive Health Alliance, Inc
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Covered Entity Details
Entity Name
Positive Health Alliance, Inc
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD322021
Entity Address
720 N Ocean Street
Jacksonville, FL 32202
Grant Number
NH25PS005131
Participating Start Date
5/8/2020
Last Recertification Date
5/28/2021
Entity Termination Date
7/1/2022
Pharmacy Details
Pharmacy Name
PHARMCO, LLC
Pharmacy Address
PHARMCO
400 ANSIN BLVD
STE A
HALLANDALE BEACH, FL 33009-3104
Pharmacy Comments
Contract Details
Approval Date
5/6/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/1/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Gary G Kogan, Executive Director
(888) 752-2267
Contract Pharmacy Representative
Pharmco, LLC
Armen Karapetyan, General Manager
(305) 919-7399 Ext: 201
Signed By Date
4/14/2020
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