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BENZER FL3 LLC
STD333192 IMG Helps Inc
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Covered Entity Details
Entity Name
IMG Helps Inc
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD333192
Entity Address
6470 NW 5th Way
Fort Lauderdale, FL 33309
Grant Number
NU62PS924633f
Participating Start Date
7/1/2021
Last Recertification Date
5/6/2024
Pharmacy Details
Pharmacy Name
BENZER FL3 LLC
Pharmacy Address
ELITE PHARMACY
901 W INDIANTOWN RD STE 23
JUPITER, FL 33458
Pharmacy Comments
Contract Details
Approval Date
5/5/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Steve Vixamar, COO
(954) 529-1178
Contract Pharmacy Representative
Benzer fl 3 llc
Tejas Patel, Pharmacist
(561) 529-2851
Signed By Date
4/13/2021
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