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866 EAST TREMONT PHARMACY LLC
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
866 EAST TREMONT PHARMACY LLC
Pharmacy Address
BOCA PHARMACY
864B E TREMONT AVE
BRONX, NY 10460
Pharmacy Comments
Contract Details
Approval Date
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tomas Wharton, President
(305) 834-9942
Contract Pharmacy Representative
866 EAST TREMONT PHARMACY LLC
Jacob Jamron, CEO
(718) 344-7853
Signed By Date
7/15/2024
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