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HEALTHYRX PHARMACY LLC
STD3280610 Sunshine Specialty Health Outreach Foundation
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Covered Entity Details
Entity Name
Sunshine Specialty Health Outreach Foundation
Subdivision Name
Gastroenterology and Nutrition
Type
Sexually Transmitted Diseases
340B ID
STD3280610
Entity Address
2880 S Osceola Ave
Orlando, FL 32806
Grant Number
5NU62PS9224532-02
Participating Start Date
4/1/2023
Last Recertification Date
5/7/2024
Entity Termination Date
7/1/2025
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
9/25/2023
Contract Begin Date
9/25/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2025
Covered Entity Terminated
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
9/25/2023
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