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ELSA PHARMACY INC
STD328089 Doctors United Group Inc
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Covered Entity Details
Entity Name
Doctors United Group Inc
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD328089
Entity Address
3300 W Colonial Drive
Orlando, FL 32808
Grant Number
NH25PS004342
Participating Start Date
1/1/2020
Last Recertification Date
5/13/2024
Pharmacy Details
Pharmacy Name
ELSA PHARMACY INC
Pharmacy Address
1802 E 4TH AVE
HIALEAH, FL 33010
Pharmacy Comments
Contract Details
Approval Date
6/7/2022
Contract Begin Date
6/9/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Augustine Carbon, President
(305) 788-0007
Contract Pharmacy Representative
Elsa Pharmacy
Julio Martin, Manager
(786) 326-5666
Signed By Date
6/7/2022
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