340B Drug Pricing Program Database
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CH042377E Northeast Florida Health Services Inc (Active)
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Main Details
Name
Northeast Florida Health Services Inc
Subdivision Name
Family Health Source
Type
HRSA-Funded Health Center
Site ID
BPS-H80-023370
340B ID
CH042377E
Grant Number
H80CS02520
Additional Details
Current Program Status
Active
Registration Date
8/6/2018
Participating Start Date
10/1/2018
Participating Approval Date
9/5/2018
Last Recertification Date
2/20/2025
Contacts
Authorizing Official
Northeast Florida Health Services, inc,
Laurie Asbury, CEO
(386) 624-1054
Primary Contact
Family Health Center
Michelle Moll, Pharmacy Director
(386) 888-4912
Addresses
Street Address
1205 S Woodland Blvd
Suite 3
Deland, FL 32720-7466
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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