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RX-MART PHARMACY
STD347416 Positive Assistance, Inc.
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Covered Entity Details
Entity Name
Positive Assistance, Inc.
Subdivision Name
Digestive & Liver Center of Florida, LLC
Type
Sexually Transmitted Diseases
340B ID
STD347416
Entity Address
737 W Oak St
Kissimmee, FL 34741
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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