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FAMILY PHYSICIANS RX
STD334301 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
STD334301
Entity Address
141 SE Avenue C
Belle Glade, FL 33430
Grant Number
NH25PS005131
Participating Start Date
10/1/2020
Last Recertification Date
Entity Termination Date
7/1/2021
Pharmacy Details
Pharmacy Name
FAMILY PHYSICIANS RX
Pharmacy Address
PHARMCORX 1103
1160 S SEMORAN BLVD STE DEF
ORLANDO, FL 32807
Pharmacy Comments
Contract Details
Approval Date
8/7/2020
Contract Begin Date
10/1/2020
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
7/1/2020
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