340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
FAMILY PHYSICIANS RX
STD331383 Pridelines Youth Services, Inc
Print
Covered Entity Details
Entity Name
Pridelines Youth Services, Inc
Subdivision Name
Pridelines
Type
Sexually Transmitted Diseases
340B ID
STD331383
Entity Address
1130 Washington Avenue
1st Floor North
Miami Beach, FL 33139
Grant Number
NU62PS924532
Participating Start Date
10/1/2022
Last Recertification Date
5/21/2025
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
1/12/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Victor Diaz-Herman, CEO
(305) 571-9601
Contract Pharmacy Representative
pharmco LLC
Pamela Roberts, COO
(303) 919-7399 Ext: 210
Signed By Date
1/12/2024
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session