Covered Entity Details

CH044245AC PANCARE OF FLORIDA, INC. (Active) - information as of 4/23/2025 10:52:01 PM

Main Details

Name

PANCARE OF FLORIDA, INC.

Subdivision Name

PanCare Health Mobile Unit #9

Type

HRSA-Funded Health Center

Site ID

BPS-H80-033510

340B ID

CH044245AC

Grant Number

H80CS06452

Additional Details

Current Program Status

Active

Registration Date

1/3/2024

Participating Start Date

4/1/2024

Participating Approval Date

1/5/2024

Last Recertification Date

2/25/2025

Contacts

Authorizing Official

PanCare of Florida, Inc.
Robert Thompson, CEO
(850) 747-5599

Primary Contact

PanCare of Florida, Inc.
Lori Barton, Pharmacy Director
(850) 818-0455

Addresses

Street Address

2309 E 15th St
Panama City, FL 32405-6345

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Last Updated On
Contract Detail	PRESCRIPTION PLACE OF	1337 US HIGHWAY 90 W		DEFUNIAK SPRINGS	FL	32433	07/02/2024	10/01/2024	10/01/2024
Contract Detail	THE PRESCRIPTION PLACE OF NICEVILLE LIC	THE PRESCRIPTION PLACE	1140 JOHN SIMS PKWY E STE 6	NICEVILLE	FL	32578	07/02/2024	10/01/2024	10/01/2024
Contract Detail	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	07/02/2024	10/01/2024	10/01/2024
Contract Detail	WAL-MART PHARMACY #10-3075	513 W. 23RD ST.		PANAMA CITY	FL	32405	07/02/2024	10/01/2024	10/01/2024
Contract Detail	WAL-MART PHARMACY 10-0818	10270 FRONT BEACH RD		PANAMA CITY BEACH	FL	32407	07/02/2024	10/01/2024	10/01/2024
Contract Detail	WAL-MART PHARMACY 10-1032	2101 S. HWY 77		LYNN HAVEN	FL	32444	07/02/2024	10/01/2024	10/01/2024
Contract Detail	WAL-MART PHARMACY 10-1207	725 N. TYNDALL PKWY.		CALLWAY	FL	32404	07/02/2024	10/01/2024	10/01/2024
Contract Detail	WAL-MART PHARMACY 10-1375	2255 HIGHWAY 71		MARIANNA	FL	32448	07/02/2024	10/01/2024	10/01/2024
Contract Detail	WAL-MART PHARMACY 10-2114	1621 MAIN STREET		CHIPLEY	FL	32428	07/02/2024	10/01/2024	10/01/2024
Contract Detail	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	07/02/2024	10/01/2024	10/01/2024
Contract Detail	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/02/2024	10/01/2024	10/01/2024
Contract Detail	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	07/02/2024	10/01/2024	10/01/2024

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH0442450	Terminated	BPS-H80-017645	PANCARE OF FLORIDA INC	DBA CHC-BAY COUNTY	403 EAST 11th STREET	PANAMA CITY	FL
CH044245AA	Active	BPS-H80-033947	Pancare of Florida Inc	PanCare Health Gulf Coast	5230 West U.S. Highway 98 BLDG Rosenwald	Panama City	FL
CH044245AB	Active	BPS-H80-031589	PANCARE OF FLORIDA, INC.	PanCare Health – Panama City	2235 E 15th St	Panama City	FL
CH044245AC	Active	BPS-H80-033510	PANCARE OF FLORIDA, INC.	PanCare Health Mobile Unit #9	2309 E 15th St	Panama City	FL
CH044245AD	Active	BPS-H80-033513	PANCARE OF FLORIDA, INC.	PanCare Health Mobile Unit #7	2309 E 15th St	Panama City	FL
CH044245AE	Active	BPS-H80-033511	PANCARE OF FLORIDA, INC.	PanCare Health Mobile Unit #6	2309 E 15th St	Panama City	FL
CH044245AF	Active	BPS-H80-033512	PANCARE OF FLORIDA, INC.	PanCare Health Mobile Unit #8	2309 E 15th St	Panama City	FL
CH044245AG	Active	BPS-H80-031989	PANCARE OF FLORIDA, INC.	PanCare Health Mobile Optometry	4126 INDEPENDENT DR	MARIANNA	FL
CH044245AH	Active	BPS-H80-037600	PANCARE OF FLORIDA, INC.	PanCare Health Mobile Unit #12	401 Cecil G Costin Sr Blvd	Port Saint Joe	FL
CH044245AJ	Active	BPS-H80-033514	PANCARE OF FLORIDA, INC.	PanCare Health Mobile Unit #5	2309 E 15th St	Panama City	FL
CH044245B	Active	BPS-H80-017645	PANCARE OF FLORIDA, INC.	PanCare Dental - Panama City	403 E11th Street	PANAMA CITY	FL
CH044245C	Active	BPS-H80-000148	PANCARE OF FLORIDA, INC.	PanCare Health - Panama City	2309 EAST 15TH STREET	PANAMA CITY	FL
CH044245D	Active	BPS-H80-009000	PANCARE OF FLORIDA INC	Freeport Clinic	479 East Hwy 20	Freeport	FL
CH044245E	Terminated	BPS-H80-010485	PANCARE OF FLORIDA INC	Muscogee Creek Indian Tribal Health Center	278 Church Rd	Bruce	FL
CH044245F	Active	BPS-H80-012767	PANCARE OF FLORIDA INC	PanCare-Liberty	11033 NW State Road 20	Bristol	FL
CH044245G	Active	BPS-H80-013427	PANCARE OF FLORIDA INC	PanCare - Chipley	1414 Main St STE 4	Chipley	FL
CH044245J	Active	BPS-H80-012076	PANCARE OF FLORIDA INC	PanCare Health Mobile Medical/Dental Unit #2	479 East Hwy 20	Freeport	FL
CH044245K	Active	BPS-H80-012765	PANCARE OF FLORIDA INC	PanCare Health Mobile Unit #4	11033 NW State Road 20	Bristol	FL
CH044245L	Active	BPS-H80-014408	PANCARE OF FLORIDA INC	PanCare-Blountstown	16875 NE Cayson St	Blountstown	FL
CH044245M	Active	BPS-H80-013714	PANCARE OF FLORIDA INC	PanCare - Bonifay	495 SAINT JOHNS RD	BONIFAY	FL
CH044245N	Active	BPS-H80-014409	PANCARE OF FLORIDA INC	PanCare Health Mobile Unit #3	495 SAINT JOHNS RD	BONIFAY	FL
CH044245P	Active	BPS-H80-036227	PANCARE OF FLORIDA INC	PanCare Health- Gulf County	401 Cecil G. Costin Sr. Blvd	Port Saint Joe	FL
CH044245Q	Active	BPS-H80-017606	PANCARE OF FLORIDA INC	PanCare Health Wewahitchka	807 Highway 22	WEWAHITCHKA	FL
CH044245R	Active	BPS-H80-018116	PANCARE OF FLORIDA INC	PanCare Carrabelle Dental	106 NE 5th Street	Carrabelle	FL
CH044245S	Active	BPS-H80-019748	PANCARE OF FLORIDA INC	PanCare Marianna	4126 INDEPENDENT DR	MARIANNA	FL
CH044245T	Active	BPS-H80-017072	Pancare of Florida Inc	PanCare Youngstown	12427 Highway 231	Youngstown	FL
CH044245U	Active	BPS-H80-029476	Pancare of Florida Inc	PanCare Health Malone	5336 10th St	Malone	FL
CH044245V	Active	BPS-H80-027534	Pancare of Florida Inc	PanCare Health Dental Mobile Unit	403 E 11th St	Panama City	FL
CH044245W	Active	BPS-H80-027533	Pancare of Florida Inc	PanCare Health Mobile Unit #1	2309 East 15th Street	Panama City	FL
CH044245X	Terminated	BPS-H80-021960	Pancare of Florida Inc	C. C. Washington and Rosenwald	924 Bay Ave	Panama City	FL
CH044245Y	Active	BPS-H80-021258	Pancare of Florida Inc	PanCare Health - Franklin County School Dental Clinic	1250 US Highway 98	Eastpoint	FL
CH044245Z	Active	BPS-H80-033133	Pancare of Florida Inc	PanCare Wellness Center	1515 June Ave	Panama City	FL

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH044245C	ADVANCED CARE SCRIPTS, INC	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	6251 CHANCELLOR DRIVE SUITE 101	ORLANDO	FL	32809	10/01/2024
CH0442450	BLOUNTSTOWN DRUG INC	20370 CENTRAL AVE W		BLOUNTSTOWN	FL	32424	10/01/2018	10/01/2022
CH044245C	BLOUNTSTOWN DRUG INC	20370 CENTRAL AVE W		BLOUNTSTOWN	FL	32424	07/01/2022
CH0442450	CALLAWAY GULF COAST PHARMACY CO	420 N TYNDALL PARKWAY		PANAMA CITY	FL	32404	01/01/2017	09/30/2018
CH044245C	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	10/01/2024
CH044245C	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	10/01/2024
CH044245C	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	10/01/2024
CH044245C	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	10/01/2024
CH044245C	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	10/01/2024
CH044245C	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	10/01/2024
CH044245C	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	10/01/2024
CH044245C	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	10/01/2024
CH044245C	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	10/01/2024
CH044245C	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	10/01/2024
CH044245C	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	10/01/2024
CH044245C	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	10/01/2024
CH0442450	GULF PHARMACY CO	GULF COAST PHARMACY	340 W 23RD ST STE D2	PANAMA CITY	FL	32405	01/01/2017	09/30/2018
CH044245C	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 03245	4684 HIGHWAY 90	MARIANNA	FL	32446	10/01/2024
CH044245C	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 04480	1037 MAIN STREET	CHIPLEY	FL	32428	10/01/2024
CH044245C	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 04500	302 N TYNDALL PKWY	PANAMA CITY	FL	32404	10/01/2024
CH044245C	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05183	660 EAST HWY 98	PANAMA CITY	FL	32401	10/01/2024
CH044245C	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05204	955 W 23RD ST	PANAMA CITY	FL	32405	10/01/2024
CH044245C	HOLIDAY CVS, L.L.C.	DBA: CVS/PHARMACY # 05246	110 HIGHWAY 98	PORT SAINT JOE	FL	32456	10/01/2024
CH044245C	HOLIDAY CVS, L.L.C.	CVS PHARMACY # 16259	2340 HIGHWAY 77	PANAMA CITY	FL	32405	10/01/2024
CH0442450	JTJ MEDICAL SUPPLY, INC	DBA MAIL MEDS CLINICAL PHARMACY	2692 OAK RIDGE CT	FORT MYERS	FL	33901	10/12/2012	10/01/2022
CH044245C	JTJ MEDICAL SUPPLY, INC	DBA MAIL MEDS CLINICAL PHARMACY	2692 OAK RIDGE CT	FORT MYERS	FL	33901	07/01/2022	11/11/2022
CH0442450	JTJ MEDICAL SUPPLY, INC.	DBA MAIL-MEDS CLINICAL PHARMACY	2200 S MONROE ST SUITE 201	TALLAHASSEE	FL	32301-6303	01/01/2020	10/01/2022
CH044245C	JTJ MEDICAL SUPPLY, INC.	DBA MAIL-MEDS CLINICAL PHARMACY	2200 S MONROE ST SUITE 201	TALLAHASSEE	FL	32301-6303	07/01/2022	11/11/2022
CH0442450	PANAMA CITY DRUGS	3127 E HIGHWAY 98		PANAMA CITY	FL	32401	01/01/2017	09/30/2018
CH044245C	PRESCRIPTION PLACE OF	1337 US HIGHWAY 90 W		DEFUNIAK SPRINGS	FL	32433	01/01/2024
CH044245G	PRESCRIPTION PLACE OF	1337 US HIGHWAY 90 W		DEFUNIAK SPRINGS	FL	32433	10/01/2024
CH044245S	PRESCRIPTION PLACE OF	1337 US HIGHWAY 90 W		DEFUNIAK SPRINGS	FL	32433	10/01/2024
CH044245P	PRESCRIPTION PLACE OF	1337 US HIGHWAY 90 W		DEFUNIAK SPRINGS	FL	32433	10/01/2024
CH044245AA	PRESCRIPTION PLACE OF	1337 US HIGHWAY 90 W		DEFUNIAK SPRINGS	FL	32433	10/01/2024
CH044245T	PRESCRIPTION PLACE OF	1337 US HIGHWAY 90 W		DEFUNIAK SPRINGS	FL	32433	10/01/2024
CH044245L	PRESCRIPTION PLACE OF	1337 US HIGHWAY 90 W		DEFUNIAK SPRINGS	FL	32433	10/01/2024
CH044245F	PRESCRIPTION PLACE OF	1337 US HIGHWAY 90 W		DEFUNIAK SPRINGS	FL	32433	10/01/2024
CH044245M	PRESCRIPTION PLACE OF	1337 US HIGHWAY 90 W		DEFUNIAK SPRINGS	FL	32433	10/01/2024
CH044245D	PRESCRIPTION PLACE OF	1337 US HIGHWAY 90 W		DEFUNIAK SPRINGS	FL	32433	10/01/2024
CH044245AC	PRESCRIPTION PLACE OF	1337 US HIGHWAY 90 W		DEFUNIAK SPRINGS	FL	32433	10/01/2024
CH044245U	PRESCRIPTION PLACE OF	1337 US HIGHWAY 90 W		DEFUNIAK SPRINGS	FL	32433	10/01/2024
CH044245AD	PRESCRIPTION PLACE OF	1337 US HIGHWAY 90 W		DEFUNIAK SPRINGS	FL	32433	10/01/2024
CH044245C	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	10/01/2024
CH044245C	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	10/01/2024
CH044245C	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	10/01/2024
CH0442450	RX EXPRESS PHARMACY OF PANAMA CITY, INC	RX EXPRESS PHARMACY	3104 W 23RD ST	PANAMA CITY	FL	32405	10/01/2016	06/01/2018
CH0442450	STEVERSON PHARMACY SERVICES, INC	DBA KING DISCOUNT DRUG	1242 MAIN ST	CHIPLEY	FL	32428	10/01/2016	10/13/2021
CH044245C	THE PRESCRIPTION PLACE OF NICEVILLE LIC	THE PRESCRIPTION PLACE	1140 JOHN SIMS PKWY E STE 6	NICEVILLE	FL	32578	01/01/2024
CH044245F	THE PRESCRIPTION PLACE OF NICEVILLE LIC	THE PRESCRIPTION PLACE	1140 JOHN SIMS PKWY E STE 6	NICEVILLE	FL	32578	10/01/2024
CH044245L	THE PRESCRIPTION PLACE OF NICEVILLE LIC	THE PRESCRIPTION PLACE	1140 JOHN SIMS PKWY E STE 6	NICEVILLE	FL	32578	10/01/2024
CH044245T	THE PRESCRIPTION PLACE OF NICEVILLE LIC	THE PRESCRIPTION PLACE	1140 JOHN SIMS PKWY E STE 6	NICEVILLE	FL	32578	10/01/2024
CH044245P	THE PRESCRIPTION PLACE OF NICEVILLE LIC	THE PRESCRIPTION PLACE	1140 JOHN SIMS PKWY E STE 6	NICEVILLE	FL	32578	10/01/2024
CH044245AA	THE PRESCRIPTION PLACE OF NICEVILLE LIC	THE PRESCRIPTION PLACE	1140 JOHN SIMS PKWY E STE 6	NICEVILLE	FL	32578	10/01/2024
CH044245D	THE PRESCRIPTION PLACE OF NICEVILLE LIC	THE PRESCRIPTION PLACE	1140 JOHN SIMS PKWY E STE 6	NICEVILLE	FL	32578	10/01/2024
CH044245G	THE PRESCRIPTION PLACE OF NICEVILLE LIC	THE PRESCRIPTION PLACE	1140 JOHN SIMS PKWY E STE 6	NICEVILLE	FL	32578	10/01/2024
CH044245M	THE PRESCRIPTION PLACE OF NICEVILLE LIC	THE PRESCRIPTION PLACE	1140 JOHN SIMS PKWY E STE 6	NICEVILLE	FL	32578	10/01/2024
CH044245S	THE PRESCRIPTION PLACE OF NICEVILLE LIC	THE PRESCRIPTION PLACE	1140 JOHN SIMS PKWY E STE 6	NICEVILLE	FL	32578	10/01/2024
CH044245AC	THE PRESCRIPTION PLACE OF NICEVILLE LIC	THE PRESCRIPTION PLACE	1140 JOHN SIMS PKWY E STE 6	NICEVILLE	FL	32578	10/01/2024
CH044245U	THE PRESCRIPTION PLACE OF NICEVILLE LIC	THE PRESCRIPTION PLACE	1140 JOHN SIMS PKWY E STE 6	NICEVILLE	FL	32578	10/01/2024
CH044245AD	THE PRESCRIPTION PLACE OF NICEVILLE LIC	THE PRESCRIPTION PLACE	1140 JOHN SIMS PKWY E STE 6	NICEVILLE	FL	32578	10/01/2024
CH044245C	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/01/2019
CH044245T	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2024
CH044245M	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2024
CH044245D	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2024
CH044245P	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2024
CH044245L	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2024
CH044245F	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2024
CH044245AA	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2024
CH044245G	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2024
CH044245S	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2024
CH044245AC	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2024
CH044245U	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2024
CH044245AD	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2024
CH0442450	WAL-MART PHARMACY #10-3075	513 W. 23RD ST.		PANAMA CITY	FL	32405	07/01/2017	10/01/2022
CH044245C	WAL-MART PHARMACY #10-3075	513 W. 23RD ST.		PANAMA CITY	FL	32405	07/01/2022
CH044245M	WAL-MART PHARMACY #10-3075	513 W. 23RD ST.		PANAMA CITY	FL	32405	10/01/2024
CH044245AA	WAL-MART PHARMACY #10-3075	513 W. 23RD ST.		PANAMA CITY	FL	32405	10/01/2024
CH044245L	WAL-MART PHARMACY #10-3075	513 W. 23RD ST.		PANAMA CITY	FL	32405	10/01/2024
CH044245D	WAL-MART PHARMACY #10-3075	513 W. 23RD ST.		PANAMA CITY	FL	32405	10/01/2024
CH044245F	WAL-MART PHARMACY #10-3075	513 W. 23RD ST.		PANAMA CITY	FL	32405	10/01/2024
CH044245S	WAL-MART PHARMACY #10-3075	513 W. 23RD ST.		PANAMA CITY	FL	32405	10/01/2024
CH044245P	WAL-MART PHARMACY #10-3075	513 W. 23RD ST.		PANAMA CITY	FL	32405	10/01/2024
CH044245T	WAL-MART PHARMACY #10-3075	513 W. 23RD ST.		PANAMA CITY	FL	32405	10/01/2024
CH044245G	WAL-MART PHARMACY #10-3075	513 W. 23RD ST.		PANAMA CITY	FL	32405	10/01/2024
CH044245AC	WAL-MART PHARMACY #10-3075	513 W. 23RD ST.		PANAMA CITY	FL	32405	10/01/2024
CH044245U	WAL-MART PHARMACY #10-3075	513 W. 23RD ST.		PANAMA CITY	FL	32405	10/01/2024
CH044245AD	WAL-MART PHARMACY #10-3075	513 W. 23RD ST.		PANAMA CITY	FL	32405	10/01/2024
CH0442450	WAL-MART PHARMACY 10-0818	10270 FRONT BEACH RD		PANAMA CITY BEACH	FL	32407	07/01/2017	10/01/2022
CH044245C	WAL-MART PHARMACY 10-0818	10270 FRONT BEACH RD		PANAMA CITY BEACH	FL	32407	07/01/2022
CH044245G	WAL-MART PHARMACY 10-0818	10270 FRONT BEACH RD		PANAMA CITY BEACH	FL	32407	10/01/2024
CH044245L	WAL-MART PHARMACY 10-0818	10270 FRONT BEACH RD		PANAMA CITY BEACH	FL	32407	10/01/2024
CH044245S	WAL-MART PHARMACY 10-0818	10270 FRONT BEACH RD		PANAMA CITY BEACH	FL	32407	10/01/2024
CH044245T	WAL-MART PHARMACY 10-0818	10270 FRONT BEACH RD		PANAMA CITY BEACH	FL	32407	10/01/2024
CH044245AA	WAL-MART PHARMACY 10-0818	10270 FRONT BEACH RD		PANAMA CITY BEACH	FL	32407	10/01/2024
CH044245D	WAL-MART PHARMACY 10-0818	10270 FRONT BEACH RD		PANAMA CITY BEACH	FL	32407	10/01/2024
CH044245F	WAL-MART PHARMACY 10-0818	10270 FRONT BEACH RD		PANAMA CITY BEACH	FL	32407	10/01/2024
CH044245M	WAL-MART PHARMACY 10-0818	10270 FRONT BEACH RD		PANAMA CITY BEACH	FL	32407	10/01/2024
CH044245P	WAL-MART PHARMACY 10-0818	10270 FRONT BEACH RD		PANAMA CITY BEACH	FL	32407	10/01/2024
CH044245AC	WAL-MART PHARMACY 10-0818	10270 FRONT BEACH RD		PANAMA CITY BEACH	FL	32407	10/01/2024
CH044245U	WAL-MART PHARMACY 10-0818	10270 FRONT BEACH RD		PANAMA CITY BEACH	FL	32407	10/01/2024
CH044245AD	WAL-MART PHARMACY 10-0818	10270 FRONT BEACH RD		PANAMA CITY BEACH	FL	32407	10/01/2024
CH0442450	WAL-MART PHARMACY 10-1032	2101 S. HWY 77		LYNN HAVEN	FL	32444	07/01/2017	10/01/2022
CH044245C	WAL-MART PHARMACY 10-1032	2101 S. HWY 77		LYNN HAVEN	FL	32444	07/01/2022
CH044245L	WAL-MART PHARMACY 10-1032	2101 S. HWY 77		LYNN HAVEN	FL	32444	10/01/2024
CH044245S	WAL-MART PHARMACY 10-1032	2101 S. HWY 77		LYNN HAVEN	FL	32444	10/01/2024
CH044245M	WAL-MART PHARMACY 10-1032	2101 S. HWY 77		LYNN HAVEN	FL	32444	10/01/2024
CH044245T	WAL-MART PHARMACY 10-1032	2101 S. HWY 77		LYNN HAVEN	FL	32444	10/01/2024
CH044245G	WAL-MART PHARMACY 10-1032	2101 S. HWY 77		LYNN HAVEN	FL	32444	10/01/2024
CH044245D	WAL-MART PHARMACY 10-1032	2101 S. HWY 77		LYNN HAVEN	FL	32444	10/01/2024
CH044245AA	WAL-MART PHARMACY 10-1032	2101 S. HWY 77		LYNN HAVEN	FL	32444	10/01/2024
CH044245F	WAL-MART PHARMACY 10-1032	2101 S. HWY 77		LYNN HAVEN	FL	32444	10/01/2024
CH044245P	WAL-MART PHARMACY 10-1032	2101 S. HWY 77		LYNN HAVEN	FL	32444	10/01/2024
CH044245AC	WAL-MART PHARMACY 10-1032	2101 S. HWY 77		LYNN HAVEN	FL	32444	10/01/2024
CH044245U	WAL-MART PHARMACY 10-1032	2101 S. HWY 77		LYNN HAVEN	FL	32444	10/01/2024
CH044245AD	WAL-MART PHARMACY 10-1032	2101 S. HWY 77		LYNN HAVEN	FL	32444	10/01/2024
CH0442450	WAL-MART PHARMACY 10-1207	725 N. TYNDALL PKWY.		CALLWAY	FL	32404	07/01/2017	10/01/2022
CH044245C	WAL-MART PHARMACY 10-1207	725 N. TYNDALL PKWY.		CALLWAY	FL	32404	07/01/2022
CH044245S	WAL-MART PHARMACY 10-1207	725 N. TYNDALL PKWY.		CALLWAY	FL	32404	10/01/2024
CH044245G	WAL-MART PHARMACY 10-1207	725 N. TYNDALL PKWY.		CALLWAY	FL	32404	10/01/2024
CH044245M	WAL-MART PHARMACY 10-1207	725 N. TYNDALL PKWY.		CALLWAY	FL	32404	10/01/2024
CH044245T	WAL-MART PHARMACY 10-1207	725 N. TYNDALL PKWY.		CALLWAY	FL	32404	10/01/2024
CH044245F	WAL-MART PHARMACY 10-1207	725 N. TYNDALL PKWY.		CALLWAY	FL	32404	10/01/2024
CH044245D	WAL-MART PHARMACY 10-1207	725 N. TYNDALL PKWY.		CALLWAY	FL	32404	10/01/2024
CH044245AA	WAL-MART PHARMACY 10-1207	725 N. TYNDALL PKWY.		CALLWAY	FL	32404	10/01/2024
CH044245P	WAL-MART PHARMACY 10-1207	725 N. TYNDALL PKWY.		CALLWAY	FL	32404	10/01/2024
CH044245L	WAL-MART PHARMACY 10-1207	725 N. TYNDALL PKWY.		CALLWAY	FL	32404	10/01/2024
CH044245AC	WAL-MART PHARMACY 10-1207	725 N. TYNDALL PKWY.		CALLWAY	FL	32404	10/01/2024
CH044245U	WAL-MART PHARMACY 10-1207	725 N. TYNDALL PKWY.		CALLWAY	FL	32404	10/01/2024
CH044245AD	WAL-MART PHARMACY 10-1207	725 N. TYNDALL PKWY.		CALLWAY	FL	32404	10/01/2024
CH0442450	WAL-MART PHARMACY 10-1375	2255 HIGHWAY 71		MARIANNA	FL	32448	04/01/2020	10/01/2022
CH044245C	WAL-MART PHARMACY 10-1375	2255 HIGHWAY 71		MARIANNA	FL	32448	07/01/2022
CH044245F	WAL-MART PHARMACY 10-1375	2255 HIGHWAY 71		MARIANNA	FL	32448	10/01/2024
CH044245L	WAL-MART PHARMACY 10-1375	2255 HIGHWAY 71		MARIANNA	FL	32448	10/01/2024
CH044245T	WAL-MART PHARMACY 10-1375	2255 HIGHWAY 71		MARIANNA	FL	32448	10/01/2024
CH044245G	WAL-MART PHARMACY 10-1375	2255 HIGHWAY 71		MARIANNA	FL	32448	10/01/2024
CH044245AA	WAL-MART PHARMACY 10-1375	2255 HIGHWAY 71		MARIANNA	FL	32448	10/01/2024
CH044245P	WAL-MART PHARMACY 10-1375	2255 HIGHWAY 71		MARIANNA	FL	32448	10/01/2024
CH044245D	WAL-MART PHARMACY 10-1375	2255 HIGHWAY 71		MARIANNA	FL	32448	10/01/2024
CH044245S	WAL-MART PHARMACY 10-1375	2255 HIGHWAY 71		MARIANNA	FL	32448	10/01/2024
CH044245M	WAL-MART PHARMACY 10-1375	2255 HIGHWAY 71		MARIANNA	FL	32448	10/01/2024
CH044245AC	WAL-MART PHARMACY 10-1375	2255 HIGHWAY 71		MARIANNA	FL	32448	10/01/2024
CH044245U	WAL-MART PHARMACY 10-1375	2255 HIGHWAY 71		MARIANNA	FL	32448	10/01/2024
CH044245AD	WAL-MART PHARMACY 10-1375	2255 HIGHWAY 71		MARIANNA	FL	32448	10/01/2024
CH0442450	WAL-MART PHARMACY 10-2114	1621 MAIN STREET		CHIPLEY	FL	32428	07/01/2017	10/01/2022
CH044245C	WAL-MART PHARMACY 10-2114	1621 MAIN STREET		CHIPLEY	FL	32428	07/01/2022
CH044245D	WAL-MART PHARMACY 10-2114	1621 MAIN STREET		CHIPLEY	FL	32428	10/01/2024
CH044245AA	WAL-MART PHARMACY 10-2114	1621 MAIN STREET		CHIPLEY	FL	32428	10/01/2024
CH044245L	WAL-MART PHARMACY 10-2114	1621 MAIN STREET		CHIPLEY	FL	32428	10/01/2024
CH044245P	WAL-MART PHARMACY 10-2114	1621 MAIN STREET		CHIPLEY	FL	32428	10/01/2024
CH044245T	WAL-MART PHARMACY 10-2114	1621 MAIN STREET		CHIPLEY	FL	32428	10/01/2024
CH044245G	WAL-MART PHARMACY 10-2114	1621 MAIN STREET		CHIPLEY	FL	32428	10/01/2024
CH044245S	WAL-MART PHARMACY 10-2114	1621 MAIN STREET		CHIPLEY	FL	32428	10/01/2024
CH044245M	WAL-MART PHARMACY 10-2114	1621 MAIN STREET		CHIPLEY	FL	32428	10/01/2024
CH044245F	WAL-MART PHARMACY 10-2114	1621 MAIN STREET		CHIPLEY	FL	32428	10/01/2024
CH044245AC	WAL-MART PHARMACY 10-2114	1621 MAIN STREET		CHIPLEY	FL	32428	10/01/2024
CH044245U	WAL-MART PHARMACY 10-2114	1621 MAIN STREET		CHIPLEY	FL	32428	10/01/2024
CH044245AD	WAL-MART PHARMACY 10-2114	1621 MAIN STREET		CHIPLEY	FL	32428	10/01/2024
CH044245C	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2019
CH044245S	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2024
CH044245F	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2024
CH044245G	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2024
CH044245M	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2024
CH044245P	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2024
CH044245AA	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2024
CH044245L	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2024
CH044245D	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2024
CH044245T	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2024
CH044245AC	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2024
CH044245U	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2024
CH044245AD	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2024
CH044245C	WALGREEN CO.	DBA: WALGREENS # 04847	1402 OHIO AVENUE	LYNN HAVEN	FL	32444	01/01/2023
CH044245C	WALGREEN CO.	DBA: WALGREENS # 05340	9998 FRONT BEACH RD.	PANAMA CITY BEACH	FL	32407	01/01/2023
CH044245C	WALGREEN CO.	DBA: WALGREENS # 06578	977 HIGHWAY 98 E	DESTIN	FL	32541	01/01/2023
CH044245C	WALGREEN CO.	DBA: WALGREENS # 06978	4582 E HIGHWAY 20	NICEVILLE	FL	32578-9724	01/01/2023
CH044245C	WALGREEN CO.	DBA: WALGREENS # 09619	301 N TYNDALL PKWY	PANAMA CITY	FL	32404	01/01/2023
CH044245C	WALGREEN CO.	DBA: WALGREENS # 09914	1103 US HIGHWAY 331 SOUTH	DEFUNIAK SPRINGS	FL	32435-3383	01/01/2023
CH044245C	WALGREEN CO.	DBA: WALGREENS # 10147	1217 W JEFFERSON ST	QUINCY	FL	32351-2125	01/01/2023
CH044245C	Walgreens #21395	Walgreens Central Fill #21395	5710 Young Pine Rd	Orlando	FL	32829	01/01/2023
CH044245C	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	10/01/2024
CH044245C	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	10/01/2024
CH044245C	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	10/01/2024
CH044245C	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2023
CH044245F	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	10/01/2024
CH044245L	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	10/01/2024
CH044245G	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	10/01/2024
CH044245AA	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	10/01/2024
CH044245D	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	10/01/2024
CH044245AC	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	10/01/2024
CH044245M	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	10/01/2024
CH044245P	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	10/01/2024
CH044245S	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	10/01/2024
CH044245T	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	10/01/2024
CH044245U	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	10/01/2024
CH044245AD	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	10/01/2024
CH044245C	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	04/01/2024
CH044245D	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/01/2024
CH044245L	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/01/2024
CH044245G	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/01/2024
CH044245F	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/01/2024
CH044245AA	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/01/2024
CH044245AC	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/01/2024
CH044245M	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/01/2024
CH044245P	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/01/2024
CH044245S	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/01/2024
CH044245T	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/01/2024
CH044245U	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/01/2024
CH044245AD	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/01/2024
CH0442450	WINN DIXIE STORES, INC	WINN DIXIE PHARMACY # 487	3157 W 23RD ST	PANAMA CITY	FL	32405	07/01/2016	06/01/2022
CH0442450	WINN DIXIE STORES, INC	WINN DIXIE PHARMACY # 488	23200 FRONT BEACH RD	PANAMA CITY	FL	32413	10/01/2018	06/01/2022
CH0442450	WINN DIXIE STORES, INC.	WINN DIXIE PHARMACY # 436	1812 HWY 77 SOUTH, SUITE 119	LYNN HAVEN	FL	32444	07/01/2016	06/01/2022
CH0442450	WINN DIXIE STORES, INC.	WINN DIXIE PHARMACY # 481	3621 US HWY 231 NORTH	PANAMA CITY	FL	32404	07/01/2016	06/01/2022
CH0442450	WINN DIXIE STORES, INC.	WINN DIXIE PHARMACY # 538	132 S TYNDALL PKWY	PARKER	FL	32404	07/01/2016	06/01/2022
CH0442450	WINN DIXIE STORES, INC.	WINN-DIXIE PHARMACY #555	4478 MARKET STREET	MARIANNA	FL	32446	10/01/2018	06/01/2022
CH0442450	WINN DIXIE STORES, INC.	WINN DIXIE PHARMACY # 552	2533 THOMAS DR	PANAMA CITY	FL	32408	10/01/2018	06/01/2022

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification		2/25/2025 10:05:13 AM	2/25/2025 10:05 AM
Details	State	Update		Approved	Active	4/1/2024 12:01 AM
Contacts	Signed By	Insert	New Registration		Thompson, Robert CEO PanCare of Florida, Inc. 8507475599	1/5/2024 9:10 AM
Details	340B ID	Update	New Registration		CH044245AC	1/5/2024 9:10 AM
Dates	Participating Approval Date	Update	New Registration		1/5/2024 9:10:25 AM	1/5/2024 9:10 AM
Details	State	Update	New Registration	Pending	Approved	1/5/2024 9:10 AM
Dates	Signed By Date	Update	New Registration		1/3/2024 1:29:03 PM	1/5/2024 9:10 AM
Dates	Start Date	Update	New Registration		4/1/2024 12:00:00 AM	1/5/2024 9:10 AM
Addresses	Main Address	Insert	New Registration		2309 E 15th St Panama City, FL 32405-6345	1/3/2024 1:21 PM
Contacts	Authorizing Official	Insert	New Registration		Thompson, Robert CEO PanCare of Florida, Inc. 8507475599	1/3/2024 1:21 PM
Contacts	Primary Contact	Insert	New Registration		Barton, Lori Pharmacy Director PanCare of Florida, Inc. 8508180455	1/3/2024 1:21 PM
Details	Assistance Received From Date	Insert	New Registration			1/3/2024 1:21 PM
Details	Assistance Received To Date	Insert	New Registration			1/3/2024 1:21 PM
Details	Last Recertification Date	Insert	New Registration			1/3/2024 1:21 PM
Details	Grant Number	Insert	New Registration		H80CS06452	1/3/2024 1:21 PM
Details	340B ID	Insert	New Registration			1/3/2024 1:21 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/3/2024 1:21 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/3/2024 1:21 PM
Details	Medicare Provider Number	Insert	New Registration			1/3/2024 1:21 PM
Details	Entity Name	Insert	New Registration		PANCARE OF FLORIDA, INC.	1/3/2024 1:21 PM
Details	NOFO Number	Insert	New Registration			1/3/2024 1:21 PM
Details	Program Code	Insert	New Registration		CH	1/3/2024 1:21 PM
Details	Entity Subname	Insert	New Registration		PanCare Health Mobile Unit #9	1/3/2024 1:21 PM
Dates	Participating Approval Date	Insert	New Registration			1/3/2024 1:21 PM
Details	State	Insert	New Registration		Pending	1/3/2024 1:21 PM
Dates	Registration Date	Insert	New Registration		1/3/2024 1:21:32 PM	1/3/2024 1:21 PM
Dates	Signed By Date	Insert	New Registration			1/3/2024 1:21 PM
Dates	Start Date	Insert	New Registration			1/3/2024 1:21 PM
Terminations	Termination Comments	Insert	New Registration			1/3/2024 1:21 PM
Terminations	Termination Date	Insert	New Registration			1/3/2024 1:21 PM
Terminations	Termination Effective Date	Insert	New Registration			1/3/2024 1:21 PM
Terminations	Termination Reason	Insert	New Registration			1/3/2024 1:21 PM

340B Drug Pricing Program Database