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FAMILY PHYSICIANS RX
STD33811 Pineapple Healthcare
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Covered Entity Details
Entity Name
Pineapple Healthcare
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33811
Entity Address
1724 33rd Street Suite 100
Orlando, FL 32839
Grant Number
NH25PS005131
Participating Start Date
9/21/2021
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
10/5/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ethan Michael Suarez, President
(407) 839-7278
Contract Pharmacy Representative
PharmCoRx
Armen Karapetyan, Director
(305) 760-2053
Signed By Date
10/5/2023
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