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ELSA PHARMACY INC
STD331661 Doctors United Group
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Covered Entity Details
Entity Name
Doctors United Group
Subdivision Name
Orange Medical & Research
Type
Sexually Transmitted Diseases
340B ID
STD331661
Entity Address
5245 NW 36th Street
STE 5257
Miami Springs, FL 33166
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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