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PINES HEALTH MART PHARMACY
STD331685 THE COMMUNITY HEALTH AND EMPOWERMENT NETWORK INC
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Covered Entity Details
Entity Name
THE COMMUNITY HEALTH AND EMPOWERMENT NETWORK INC
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD331685
Entity Address
809 NW 119th Street
North Miami, FL 33168
Grant Number
NH25PS005131
Participating Start Date
3/14/2022
Last Recertification Date
5/29/2024
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
10/17/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2023
Agreement registered in error
Contacts
Covered Entity Signing Official
Micaelle Titus, Executive Director
(786) 407-0308
Contract Pharmacy Representative
Pines Health Mart Pharmacy
Mohammed Arshad Ali, CEO
(954) 404-6610
Signed By Date
10/17/2022
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