Contract Pharmacy Details

HEALTHYRX PHARMACY LLC
STD33837 Aum International Foundation, Inc.

Covered Entity Details

Entity Name

Aum International Foundation, Inc.

Subdivision Name

Suma & Durga PA.

Type

Sexually Transmitted Diseases

340B ID

STD33837

Entity Address

2243 North Blvd W
Davenport, FL 33837

Grant Number

5H25PS004342

Participating Start Date

8/3/2020

Last Recertification Date

5/7/2021

Entity Termination Date

1/1/2022

Pharmacy Details

Pharmacy Name

HEALTHYRX PHARMACY LLC

Pharmacy Address

DBA-HEALTHYRX PHARMACY
650 NW 120TH ST
NORTH MIAMI, FL 33168

Pharmacy Comments

Contract Details

Approval Date

8/3/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2022
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Ganesh Ramachandran, President
(407) 970-5253

Contract Pharmacy Representative

HealthyRx Pharmacy
Ajay Kolla, President
(352) 598-9828

Signed By Date

7/14/2020

340B Drug Pricing Program Database