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HEALTHYRX PHARMACY LLC
STD3280612 Sunshine Specialty Health Outreach Foundation
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Covered Entity Details
Entity Name
Sunshine Specialty Health Outreach Foundation
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD3280612
Entity Address
220 E. Gore St
Orlando, FL 32806
Grant Number
5nu62ps924532-02
Participating Start Date
10/12/2022
Last Recertification Date
5/7/2024
Pharmacy Details
Pharmacy Name
HEALTHYRX PHARMACY LLC
Pharmacy Address
DBA-HEALTHYRX PHARMACY
650 NW 120TH ST
NORTH MIAMI, FL 33168
Pharmacy Comments
Contract Details
Approval Date
9/22/2023
Contract Begin Date
9/22/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/15/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jillian Hall, CEO
(407) 888-5980
Contract Pharmacy Representative
Healthyrx Pharmacy
Sowjanya Shakhamoori, President
(954) 355-7744
Signed By Date
9/22/2023
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