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HEALTHSMART DISCOUNT PHARMACY
CH040380 NORTH FLORIDA MEDICAL CENTERS, INC.
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Covered Entity Details
Entity Name
NORTH FLORIDA MEDICAL CENTERS, INC.
Subdivision Name
North Florida Medical Centers, Inc.
Type
HRSA-Funded Health Center
340B ID
CH040380
Entity Address
2804 Remington Green Cir
Tallahassee, FL 32308-8707
Grant Number
H80CS00693
Participating Start Date
4/1/2001
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
HEALTHSMART DISCOUNT PHARMACY
Pharmacy Address
HEALTH SMART PHARMACY, INC.
5809 HIGHWAY 189 N
BAKER, FL 32531-2501
Pharmacy Comments
Contract Details
Approval Date
7/19/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/19/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Tori Wiggins, CFO
(850) 298-6040
Contract Pharmacy Representative
Signed By Date
7/19/2015
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