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EZ RX BONITA SPRINGS LLC
STD331791 Anuvia Medical Center
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Covered Entity Details
Entity Name
Anuvia Medical Center
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD331791
Entity Address
190 NE 199th Street
Suite 201
Miami, FL 33179
Grant Number
NH25PS005131
Participating Start Date
10/1/2023
Last Recertification Date
5/6/2025
Pharmacy Details
Pharmacy Name
EZ RX BONITA SPRINGS LLC
Pharmacy Address
MY CHOICE RX
13141 MCGREGOR BLVD STE 7
FORT MYERS, FL 33919
Pharmacy Comments
Contract Details
Approval Date
1/10/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Venise Danda, Owner
(786) 589-7840
Contract Pharmacy Representative
EZRX PHARMACY
MIRTHA GONZALEZ, PHARMACY TECH
(786) 259-3076
Signed By Date
1/10/2025
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