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Walgreens #21395
STD347419 Positive Assistance, Inc.
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Covered Entity Details
Entity Name
Positive Assistance, Inc.
Subdivision Name
NU HEALTHCARE INC.
Type
Sexually Transmitted Diseases
340B ID
STD347419
Entity Address
1016 Mann St
Kissimmee, FL 34741
Grant Number
5NU62PS924532-02
Participating Start Date
7/1/2023
Last Recertification Date
5/20/2024
Entity Termination Date
7/1/2025
Pharmacy Details
Pharmacy Name
Walgreens #21395
Pharmacy Address
Walgreens Central Fill #21395
5710 Young Pine Rd
Orlando, FL 32829
Pharmacy Comments
Contract Details
Approval Date
7/7/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Andre J Antenor, President
(863) 242-3322
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/7/2023
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