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GOLDEN HILLS PHARMACY, LLC
STD333112 WellView Care
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Covered Entity Details
Entity Name
WellView Care
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD333112
Entity Address
906 WEST SUNRISE BLVD
A
Fort Lauderdale, FL 33311
Grant Number
NH25PS005131
Participating Start Date
4/1/2021
Last Recertification Date
5/6/2025
Pharmacy Details
Pharmacy Name
GOLDEN HILLS PHARMACY, LLC
Pharmacy Address
2053 N. UNIVERSITY DR,
SUNRISE, FL 33322
Pharmacy Comments
Contract Details
Approval Date
4/15/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2025
Pharmacy closed
Contacts
Covered Entity Signing Official
Adolfo Lorenzo, President
(305) 491-3600
Contract Pharmacy Representative
GOLDEN HILLS PHARMACY LLC
Bob Hopta, GM
(561) 504-0612
Signed By Date
4/15/2021
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