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KNAP INC.
STD339016 Blue Star Health
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Covered Entity Details
Entity Name
Blue Star Health
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD339016
Entity Address
3660 Central Ave Unit 7
Fort Myers, FL 33901
Grant Number
NH25PS005131
Participating Start Date
4/1/2021
Last Recertification Date
5/15/2024
Pharmacy Details
Pharmacy Name
KNAP INC.
Pharmacy Address
CARRELL DISCOUNT PHARMACY
3547 CLEVELAND AVE
FORT MYERS, FL 33901-7903
Pharmacy Comments
Contract Details
Approval Date
10/12/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Fabio Ruiz, CEO
(866) 725-4642
Contract Pharmacy Representative
KNAP INC
AMI Patel, P
(732) 306-3987
Signed By Date
10/12/2021
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