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PRX INCORPORATED
STD328087 Comprehensive Health Center, LLC
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Covered Entity Details
Entity Name
Comprehensive Health Center, LLC
Subdivision Name
Comprehensive Health Of Orlando
Type
Sexually Transmitted Diseases
340B ID
STD328087
Entity Address
1011 W Oakridge Road
Orlando, FL 32809
Grant Number
NH25P5004342-04-01
Participating Start Date
10/1/2018
Last Recertification Date
5/7/2024
Pharmacy Details
Pharmacy Name
PRX INCORPORATED
Pharmacy Address
PRX PHARMACY
5040 NW 7TH ST SUITE 470
MIAMI, FL 33126
Pharmacy Comments
Contract Details
Approval Date
7/1/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/28/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Mary Ballantine, Executive Director
(305) 688-0811
Contract Pharmacy Representative
PRX Incorporated
Francisco Urteaga, CEO
(305) 496-9038
Signed By Date
7/1/2020
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