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FAMILY PHYSICIANS RX
STD33029 First Class OBGYN
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Covered Entity Details
Entity Name
First Class OBGYN
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33029
Entity Address
1951 SW 172nd avenue
Suite 212
Miramar, FL 33029
Grant Number
NH25PS005131
Participating Start Date
1/1/2025
Last Recertification Date
5/7/2025
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
11/25/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Darlene Mejia, Office Manager
(305) 962-8374
Contract Pharmacy Representative
Pharmco
Carlos Rangel, Director of Marketing Operations
(305) 760-2053
Signed By Date
10/11/2024
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