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RPH SOLUTION INC
STD337813 Inclusive Care Group
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Covered Entity Details
Entity Name
Inclusive Care Group
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD337813
Entity Address
7800 66th street North
Suite 204
Pinellas Park, FL 33781
Grant Number
NH25PS005131
Participating Start Date
4/1/2024
Last Recertification Date
5/6/2024
Pharmacy Details
Pharmacy Name
RPH SOLUTION INC
Pharmacy Address
BELL PHARMACY 003
1246 RAY CHARLES BLVD.
TAMPA, FL 33602
Pharmacy Comments
Contract Details
Approval Date
4/8/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Antonio Luis, Phycisian, Excecutive Director
(727) 753-7787
Contract Pharmacy Representative
Bell Pharmacy
Anthony Pasquale Trunzo, Mananger
(813) 689-2273
Signed By Date
4/8/2024
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