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KAILASHRX LLC
STD327201 Rising Against All Odds, Inc.
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Covered Entity Details
Entity Name
Rising Against All Odds, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD327201
Entity Address
340 S Woodland Blvd
Deland, FL 32720
Grant Number
NH25PS004342
Participating Start Date
1/1/2019
Last Recertification Date
5/10/2024
Pharmacy Details
Pharmacy Name
KAILASHRX LLC
Pharmacy Address
DBA: COMMUNITY PHARMACY OF DELTONA
1240 PROVIDENCE BLVD UNIT 1&2
DELTONA, FL 32725
Pharmacy Comments
Contract Details
Approval Date
1/14/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brenda Flowers, Executive Director
(386) 215-7881
Contract Pharmacy Representative
Deltona Pharmacy
jayesh mehta, Pharmacy
(407) 729-2870
Signed By Date
1/14/2024
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