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RUDHRA LLC/DBA UNIVERSITY PHARMACY
STD34240 Doctor's Goodwill Foundation Inc
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Covered Entity Details
Entity Name
Doctor's Goodwill Foundation Inc
Subdivision Name
University Family
Type
Sexually Transmitted Diseases
340B ID
STD34240
Entity Address
6731 Professional Pwk W
Sarasota, FL 34240
Grant Number
H25PS005131
Participating Start Date
7/1/2021
Last Recertification Date
5/11/2022
Entity Termination Date
10/1/2022
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
5/5/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2022
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
4/15/2021
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