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PINES HEALTH MART PHARMACY
STD331501 Doctors United group
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Covered Entity Details
Entity Name
Doctors United group
Subdivision Name
62nd
Type
Sexually Transmitted Diseases
340B ID
STD331501
Entity Address
714 NW 62nd street
Miami, FL 33150
Grant Number
NH25PS004342
Participating Start Date
1/1/2022
Last Recertification Date
5/13/2024
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
11/21/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/22/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Augustine Carbon, President
(305) 788-0007
Contract Pharmacy Representative
Pineshealthmartpharmacy@gmail.com
Arshad Mohammed, Pharmacist/ owner
(954) 404-6610
Signed By Date
10/14/2022
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