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PINES HEALTH MART PHARMACY
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
PINES HEALTH MART PHARMACY
Pharmacy Address
2301 N UNIVERSITY DR STE 112
PEMBROKE PINES, FL 33024-3617
Pharmacy Comments
Contract Details
Approval Date
11/22/2022
Contract Begin Date
1/1/2023
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
Pines Health Mart Pharmacy
Mohammed Arshad Ali, CEO
(954) 404-6610
Signed By Date
11/22/2022
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