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H&R PHARMACY
STD32724 Home Of Grace INC
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Covered Entity Details
Entity Name
Home Of Grace INC
Subdivision Name
Home Of Grace INC
Type
Sexually Transmitted Diseases
340B ID
STD32724
Entity Address
230 E New York Ave
Deland, FL 32724
Grant Number
H25PS005131
Participating Start Date
7/20/2022
Last Recertification Date
5/13/2024
Pharmacy Details
Pharmacy Name
H&R PHARMACY
Pharmacy Address
HR RX LLC
870 SAXON BLVD STE 45
ORANGE CITY, FL 32763-8209
Pharmacy Comments
Contract Details
Approval Date
7/14/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Adaobi Oguchi, President
(407) 402-6324
Contract Pharmacy Representative
HR RX LLC
Hany Badawy, Rph/owner
(386) 218-0926
Signed By Date
7/14/2023
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