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MAGGIE'S PHARMACY INC
STD328041 ALLIED HEALTH ORGANIZATION INC
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Covered Entity Details
Entity Name
ALLIED HEALTH ORGANIZATION INC
Subdivision Name
Orlando Location
Type
Sexually Transmitted Diseases
340B ID
STD328041
Entity Address
6889 W Colonial Drive # 28
Orlando, FL 32804-0000
Grant Number
NH25PS005131
Participating Start Date
8/3/2020
Last Recertification Date
Entity Termination Date
7/1/2021
Pharmacy Details
Pharmacy Name
MAGGIE'S PHARMACY INC
Pharmacy Address
7590 NW 186TH ST STE 109
HIALEAH, FL 33015
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
7/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Alejandro J Castro, CEO
(954) 446-3204
Contract Pharmacy Representative
Physician Preferred Pharmacy
Twiggi Batista Batista, CEO
(786) 523-8752
Signed By Date
7/15/2020
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