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LINTON SQUARE PHARMACY & MEDICAL SUPPLIE
STD334041 INTEGRATED HEALTHCARE SYSTEMS RIVIERA INC
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Covered Entity Details
Entity Name
INTEGRATED HEALTHCARE SYSTEMS RIVIERA INC
Subdivision Name
INTEGRATED HEALTHCARE SYSTEMS
Type
Sexually Transmitted Diseases
340B ID
STD334041
Entity Address
800 N Sapodilla Avenue
STE 3
West Palm Beach, FL 33401-6155
Grant Number
NH25PS005131
Participating Start Date
4/1/2020
Last Recertification Date
5/6/2024
Pharmacy Details
Pharmacy Name
LINTON SQUARE PHARMACY & MEDICAL SUPPLIE
Pharmacy Address
RXVIP
1601 S. CONGRESS AVE
DELRAY BEACH, FL 33445
Pharmacy Comments
Contract Details
Approval Date
7/15/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/30/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Monique D Brown Wellons, CEO
(561) 510-0471
Contract Pharmacy Representative
Linton Square Pharmacy
William Barnhart, Pharmacy Manager
(561) 272-0015
Signed By Date
7/15/2021
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