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PALM BAY RX PHARMACY LLC
STD329221 Specialized Treatment Education and Prevention Services, Inc
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Covered Entity Details
Entity Name
Specialized Treatment Education and Prevention Services, Inc
Subdivision Name
STEPS Cocoa
Type
Sexually Transmitted Diseases
340B ID
STD329221
Entity Address
803 N. Fiske Blvd
Cocoa, FL 32922
Grant Number
H25PS005131
Participating Start Date
4/1/2022
Last Recertification Date
5/6/2024
Pharmacy Details
Pharmacy Name
PALM BAY RX PHARMACY LLC
Pharmacy Address
PALM BAY PHARMACY
1270 MALABAR RD SE STE 2
PALM BAY, FL 32907
Pharmacy Comments
Contract Details
Approval Date
4/14/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Cheryl Bello, Executive Director
(407) 522-2144
Contract Pharmacy Representative
RX One
Sam Sharma, Regional Manager
(321) 952-0656
Signed By Date
4/14/2023
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