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ELSA PHARMACY INC
STD33004 Doctors United Group Inc
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Covered Entity Details
Entity Name
Doctors United Group Inc
Subdivision Name
Dania Beach
Type
Sexually Transmitted Diseases
340B ID
STD33004
Entity Address
329 South Federal Highway
Dania Beach, FL 33004
Grant Number
NH25PS004342
Participating Start Date
12/12/2023
Last Recertification Date
5/13/2024
Pharmacy Details
Pharmacy Name
ELSA PHARMACY INC
Pharmacy Address
1802 E 4TH AVE
HIALEAH, FL 33010
Pharmacy Comments
Contract Details
Approval Date
12/12/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Khadijah Carbon, Vice President
(305) 879-9749
Contract Pharmacy Representative
Elsa Pharmacy Inc
David Sampedro, Pharmacy Manager
(305) 691-1968
Signed By Date
11/16/2023
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