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NMB PHARMACY INC
STD15801 TruCare Internal Medicine & Infectious Diseases
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Covered Entity Details
Entity Name
TruCare Internal Medicine & Infectious Diseases
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD15801
Entity Address
135 Midway Drive
Suite B
DU BOIS, PA 15801
Grant Number
NH25PS005144
Participating Start Date
10/1/2019
Last Recertification Date
5/5/2025
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
4/17/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/13/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Tuesdae Stainbrook, DO, MPH
(814) 371-2348
Contract Pharmacy Representative
Trupill
Peter Park, General Manager of New Ventures
(812) 320-8057
Signed By Date
4/17/2023
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