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NMB PHARMACY INC
STD292041 Palmetto AIDS Life Support Services, Inc.
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Covered Entity Details
Entity Name
Palmetto AIDS Life Support Services, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD292041
Entity Address
2638 Two Notch Road
Suite 108
Columbia, SC 29204
Grant Number
NH25PS005150
Participating Start Date
10/1/2016
Last Recertification Date
5/12/2025
Pharmacy Details
Pharmacy Name
NMB PHARMACY INC
Pharmacy Address
1203 NE 163RD ST STE 103
NORTH MIAMI BEACH, FL 33162
Pharmacy Comments
Contract Details
Approval Date
1/13/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Carmen H. Julious, CEO
(803) 779-7257
Contract Pharmacy Representative
TruePill
Mario Maceira, Senior Manager
(407) 484-3901
Signed By Date
1/13/2023
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