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NORTH FLORIDA PHARMACY, INC
CH048970 TRENTON MEDICAL CENTER
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Covered Entity Details
Entity Name
TRENTON MEDICAL CENTER
Subdivision Name
Palms Medical Group - Lake City
Type
HRSA-Funded Health Center
340B ID
CH048970
Entity Address
173 NW Albritton Ln
Lake City, FL 32055-4451
Grant Number
H80CS00691
Participating Start Date
1/1/2002
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
NORTH FLORIDA PHARMACY, INC
Pharmacy Address
NORTH FLORIDA PHARMACY
347 SW MAIN BLVD STE 102
LAKE CITY, FL 32025-5262
Pharmacy Comments
Contract Details
Approval Date
7/1/2005
Contract Begin Date
7/1/2005
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
6/14/2005
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