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FAMILY PHYSICIANS RX
STD33410 Healthy MD Clinical, LLC (f.k.a. Independent Medical Group, LLC)
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Covered Entity Details
Entity Name
Healthy MD Clinical, LLC (f.k.a. Independent Medical Group, LLC)
Subdivision Name
Palm Beach
Type
Sexually Transmitted Diseases
340B ID
STD33410
Entity Address
4360 Northlake Blvd.
Suite 115
Palm Beach Gardens, FL 33410
Grant Number
NH25PS004342-04-01
Participating Start Date
10/1/2021
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
FAMILY PHYSICIANS RX
Pharmacy Address
PHARMCORX 1103
1160 S SEMORAN BLVD STE DEF
ORLANDO, FL 32807
Pharmacy Comments
Contract Details
Approval Date
9/19/2023
Contract Begin Date
9/20/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Steve Vixamar, COO
(954) 529-1178
Contract Pharmacy Representative
pharmco LLC
Pamela Roberts, COO
(303) 919-7399 Ext: 210
Signed By Date
9/19/2023
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