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ELSA PHARMACY INC
STD331741 FloriMed Medical Center
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Covered Entity Details
Entity Name
FloriMed Medical Center
Subdivision Name
FloriMed Medical Center @ Sweetwater
Type
Sexually Transmitted Diseases
340B ID
STD331741
Entity Address
111 S.W. 107TH AVE
MIAMI, FL 33174
Grant Number
NH25PS005131
Participating Start Date
7/1/2024
Last Recertification Date
Pharmacy Details
Pharmacy Name
ELSA PHARMACY INC
Pharmacy Address
1802 E 4TH AVE
HIALEAH, FL 33010
Pharmacy Comments
Contract Details
Approval Date
6/13/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tomas Wharton, CEO
(305) 834-9942
Contract Pharmacy Representative
Elsa Pharmacy Inc
David Sampedro, Pharmacy Manager
(305) 691-1968
Signed By Date
4/6/2024
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