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PINES HEALTH MART PHARMACY
RWI33071 COMMUNITY RIGHTFUL CENTER
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Covered Entity Details
Entity Name
COMMUNITY RIGHTFUL CENTER
Subdivision Name
Type
Ryan White Part A
340B ID
RWI33071
Entity Address
1801 N. UNIVERSITY DRIVE
210
CAROL SPRING, FL 33071
Grant Number
H89HA00002
Participating Start Date
10/1/2021
Last Recertification Date
3/10/2025
Pharmacy Details
Pharmacy Name
PINES HEALTH MART PHARMACY
Pharmacy Address
2301 N UNIVERSITY DR STE 112
PEMBROKE PINES, FL 33024-3617
Pharmacy Comments
Contract Details
Approval Date
10/14/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Roseline Lous XVI, CEO/ director
(305) 754-5701
Contract Pharmacy Representative
Pines Health Mart Pharmacy
Mohammed Arshad Ali, CEO
(954) 404-6610
Signed By Date
10/14/2022
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