Contract Pharmacy Details

BLOUNTSTOWN DRUG INC
CH0442450 PANCARE OF FLORIDA INC

Covered Entity Details

Entity Name

PANCARE OF FLORIDA INC

Subdivision Name

DBA CHC-BAY COUNTY

Type

HRSA-Funded Health Center

340B ID

CH0442450

Entity Address

403 EAST 11th STREET
PANAMA CITY, FL 32401

Grant Number

H80CS06452

Participating Start Date

7/1/2006

Last Recertification Date

2/3/2022

Entity Termination Date

10/1/2022

Pharmacy Details

Pharmacy Name

BLOUNTSTOWN DRUG INC

Pharmacy Address

20370 CENTRAL AVE W
BLOUNTSTOWN, FL 32424

Pharmacy Comments

Contract Details

Approval Date

7/13/2018

Contract Begin Date

10/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/1/2022
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Michael R. Hill, President/CEO
(850) 747-5599

Contract Pharmacy Representative

corporation
Jon Plummer, Owner
(850) 674-2222

Signed By Date

7/13/2018