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RX-MART PHARMACY
STD344715 Positive Assistance, Inc.
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Covered Entity Details
Entity Name
Positive Assistance, Inc.
Subdivision Name
Infectious Diseases Associates Of North Central Florida, LLC
Type
Sexually Transmitted Diseases
340B ID
STD344715
Entity Address
3306 SW 26th Ave
Suite 104
Ocala, FL 34471
Grant Number
NU62PS924532-02
Participating Start Date
1/1/2022
Last Recertification Date
5/12/2025
Pharmacy Details
Pharmacy Name
RX-MART PHARMACY
Pharmacy Address
RX MART PHARMACY
665 STATE ROAD 207
STE 101
SAINT AUGUSTINE, FL 32084
Pharmacy Comments
Contract Details
Approval Date
1/13/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Andre J Antenor, President
(863) 242-3322
Contract Pharmacy Representative
HEALTHYRX PHARMACY LLC
Sowjanya Shakhamoori, PHARMACIST
(813) 626-7353
Signed By Date
1/13/2022
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