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ELSA PHARMACY INC
STD330301 FLORIMED MEDICAL CENTER
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Covered Entity Details
Entity Name
FLORIMED MEDICAL CENTER
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD330301
Entity Address
311 N.E. 8 STREET
SUITE 110
HOMESTEAD, FL 33030
Grant Number
NH25P5004342
Participating Start Date
8/26/2024
Last Recertification Date
Pharmacy Details
Pharmacy Name
ELSA PHARMACY INC
Pharmacy Address
1802 E 4TH AVE
HIALEAH, FL 33010
Pharmacy Comments
Contract Details
Approval Date
10/15/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Tomas Wharton, CEO
(305) 834-9942
Contract Pharmacy Representative
Elsa Pharmacy Inc
David Sampedro, Pharmacy Manager
(305) 691-1968
Signed By Date
10/15/2020
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