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RUDHRA LLC/DBA UNIVERSITY PHARMACY
STD33983 Doctor's Goodwill Foundation Inc
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Covered Entity Details
Entity Name
Doctor's Goodwill Foundation Inc
Subdivision Name
Dr. Dratler
Type
Sexually Transmitted Diseases
340B ID
STD33983
Entity Address
24430 Sandhill Blvd Unit 303
Punta Gorda, FL 33983
Grant Number
H25PS005131
Participating Start Date
4/1/2021
Last Recertification Date
5/11/2022
Entity Termination Date
7/1/2022
Pharmacy Details
Pharmacy Name
RUDHRA LLC/DBA UNIVERSITY PHARMACY
Pharmacy Address
UNIVERSITY PHARMACY
8451 SHADE AVE STE 108
SARASOTA, FL 34243-2878
Pharmacy Comments
Contract Details
Approval Date
2/12/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2022
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Kantilal Bhalani, CEO
(321) 298-5531 Ext: 9414416212
Contract Pharmacy Representative
Rudhra LLC
Pinel Shah, Owner
(941) 355-2500
Signed By Date
1/15/2021
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