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PRX INCORPORATED
STD33012 Project Access Foundation, Inc
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Covered Entity Details
Entity Name
Project Access Foundation, Inc
Subdivision Name
Hialeah Medical
Type
Sexually Transmitted Diseases
340B ID
STD33012
Entity Address
1435 W 49TH STREET
503
HIALEAH, FL 33012
Grant Number
NH25PS005131
Participating Start Date
10/1/2018
Last Recertification Date
5/9/2025
Pharmacy Details
Pharmacy Name
PRX INCORPORATED
Pharmacy Address
PRX PHARMACY
5040 NW 7TH ST SUITE 470
MIAMI, FL 33126
Pharmacy Comments
Contract Details
Approval Date
2/2/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Steve Vixamar, COO
(954) 529-1178
Contract Pharmacy Representative
PRX Incorporated
Francisco Urteaga, CEO
(305) 496-9038
Signed By Date
1/9/2018
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