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JCR MEDICAL EQUIPMENT INC
STD330121 Doctors United Group Inc
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Covered Entity Details
Entity Name
Doctors United Group Inc
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD330121
Entity Address
4212 W 16 AV
Hialeah, FL 33012
Grant Number
NH25PS004342
Participating Start Date
1/1/2020
Last Recertification Date
5/22/2023
Entity Termination Date
4/1/2024
Pharmacy Details
Pharmacy Name
JCR MEDICAL EQUIPMENT INC
Pharmacy Address
UNIFIED CARE SERVICES MEDICAL EQUIPMENT
10650 NW 29TH TER
DORAL, FL 33172-2195
Pharmacy Comments
Contract Details
Approval Date
4/12/2021
Contract Begin Date
4/12/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Augustine Carbon, President
(305) 788-0007
Contract Pharmacy Representative
JCR Medical Equipment
Jose Rodriguez, Manager
(305) 262-7004
Signed By Date
4/12/2021
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