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PUBLIX SUPER MARKETS, INC.
CHC26592-00 Coastal Community Health Services, Inc.
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Covered Entity Details
Entity Name
Coastal Community Health Services, Inc.
Subdivision Name
Coastal Community Health Services
Type
HRSA-Funded Health Center
340B ID
CHC26592-00
Entity Address
106 Shoppers Way, Unit 1
Brunswick, GA 31525
Grant Number
H80CS26592
Participating Start Date
10/1/2014
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
PUBLIX SUPER MARKETS, INC.
Pharmacy Address
PUBLIX PHARMACY #3213
1950 SAND LAKE RD, BLDG #5
ORLANDO, FL 32809
Pharmacy Comments
Contract Details
Approval Date
10/12/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Barbara Meyers, CEO
(912) 574-5074
Contract Pharmacy Representative
Publix
Kimberly Bone, Manager of Managed Care, Pharmacy Operations
(863) 688-1188 Ext: 52364
Signed By Date
10/12/2018
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