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SOLERA SPECIALTY PHARMACY, LLC
STD330302 Mani Medical Center
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Covered Entity Details
Entity Name
Mani Medical Center
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD330302
Entity Address
151 NW 11th Street
W303
Homestead, FL 33030
Grant Number
NH25PS005131
Participating Start Date
12/7/2021
Last Recertification Date
5/9/2024
Pharmacy Details
Pharmacy Name
SOLERA SPECIALTY PHARMACY, LLC
Pharmacy Address
SOLERA SPECIALTY PHARMACY
2100 PARK CENTRAL BLVD N STE 300
POMPANO BEACH, FL 33064-2219
Pharmacy Comments
Contract Details
Approval Date
12/7/2021
Contract Begin Date
12/7/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/16/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Steve Taylor, CEO/Present
(954) 854-7475
Contract Pharmacy Representative
Solera Specialty Pharmacy
Richard Dougherty, COO
(877) 712-7864
Signed By Date
11/3/2021
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