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PHYSICIAN PREFERRED PHARMACY
STD330122 Allied Health Organization INC
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Covered Entity Details
Entity Name
Allied Health Organization INC
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD330122
Entity Address
3762 W 12 Avenue
Hialeah, FL 33012-0000
Grant Number
NH25PS005131
Participating Start Date
8/3/2020
Last Recertification Date
6/6/2022
Entity Termination Date
7/1/2023
Pharmacy Details
Pharmacy Name
PHYSICIAN PREFERRED PHARMACY
Pharmacy Address
2700 N STATE ROAD 7
MARGATE, FL 33063
Pharmacy Comments
Contract Details
Approval Date
8/3/2020
Contract Begin Date
8/3/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Alejandro J Castro, CEO
(954) 446-3204
Contract Pharmacy Representative
Physician Preferred Pharmacy
Twiggi Batista, Pharmacist
(954) 960-7360
Signed By Date
7/15/2020
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