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BENZER FL3 LLC
STD327636 Sirius Healthcare LLC
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Covered Entity Details
Entity Name
Sirius Healthcare LLC
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD327636
Entity Address
296 Treemonte Drive
296
Orange City, FL 32763
Grant Number
NH25PS0051310504
Participating Start Date
1/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
BENZER FL3 LLC
Pharmacy Address
ELITE PHARMACY
901 W INDIANTOWN RD STE 23
JUPITER, FL 33458
Pharmacy Comments
Contract Details
Approval Date
12/20/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ramonita Perez, COO
(888) 808-1540
Contract Pharmacy Representative
Benzer fl 3 llc
Tejas Patel, Pharmacist
(561) 529-2851
Signed By Date
12/20/2024
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