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ELSA PHARMACY INC
STD330132 SOCORRO HEALTH INC
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Covered Entity Details
Entity Name
SOCORRO HEALTH INC
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD330132
Entity Address
777 EAST 25 STREET
308
HIALEAH, FL 33013
Grant Number
NU62PS924532
Participating Start Date
10/12/2022
Last Recertification Date
5/6/2024
Pharmacy Details
Pharmacy Name
ELSA PHARMACY INC
Pharmacy Address
1802 E 4TH AVE
HIALEAH, FL 33010
Pharmacy Comments
Contract Details
Approval Date
10/12/2022
Contract Begin Date
10/12/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ciomara Socorro, CEO
(954) 696-3093
Contract Pharmacy Representative
Elsa Pharmacy
Julio Martin, Manager
(786) 326-5666
Signed By Date
9/23/2022
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