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RELIABLE SUPER DRUGS OF MIAMI LLC
STD33181 Advanced Care Services, Inc
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Covered Entity Details
Entity Name
Advanced Care Services, Inc
Subdivision Name
J&C Healthcare Center
Type
Sexually Transmitted Diseases
340B ID
STD33181
Entity Address
1620 NE 148t Street
North Miami, FL 33181
Grant Number
5NU62PS92453202
Participating Start Date
1/1/2022
Last Recertification Date
5/8/2024
Pharmacy Details
Pharmacy Name
RELIABLE SUPER DRUGS OF MIAMI LLC
Pharmacy Address
2168 NE 123RD ST
NORTH MIAMI, FL 33181-2902
Pharmacy Comments
Contract Details
Approval Date
5/3/2023
Contract Begin Date
5/9/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Terry Leno, CEO
(786) 488-9030
Contract Pharmacy Representative
Reliable Super Drugs
Sapna Charania, Pharmacist
(305) 893-5252
Signed By Date
5/3/2023
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