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QUICK SCRIPT PHARMACY
STD33308 Light Of Hope, Inc.
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Covered Entity Details
Entity Name
Light Of Hope, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33308
Entity Address
3012 E Commercial Blvd.
Fort Lauderdale, FL 33308
Grant Number
NH25PS004342
Participating Start Date
7/1/2019
Last Recertification Date
5/7/2025
Pharmacy Details
Pharmacy Name
QUICK SCRIPT PHARMACY
Pharmacy Address
2408 WILTON DR
WILTON MANORS, FL 33305
Pharmacy Comments
Contract Details
Approval Date
1/17/2023
Contract Begin Date
1/23/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Stephen A Renae, Medical Director
(954) 776-9992 Ext: 100
Contract Pharmacy Representative
Quick Script Pharmacy
Hussein Fawaz, Owner/Manager
(954) 514-7685
Signed By Date
1/17/2023
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