Contract Pharmacy Details

PUBLIX PHARMACY #1444
STD32763 26Health, Inc.

Covered Entity Details

Entity Name

26Health, Inc.

Subdivision Name

Gastroenterology of Greater Orlando, LLC

Type

Sexually Transmitted Diseases

340B ID

STD32763

Entity Address

2884 Wellness Ave
402
Orange City, FL 32763

Grant Number

1H25PS004342-02

Participating Start Date

7/1/2019

Last Recertification Date

5/4/2020

Entity Termination Date

10/1/2020

Pharmacy Details

Pharmacy Name

PUBLIX PHARMACY #1444

Pharmacy Address

299 EAST INTERNATIONAL SPEEDWAY BLVD.
DELAND, FL 32724

Pharmacy Comments

Contract Details

Approval Date

7/15/2019

Contract Begin Date

10/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/8/2020
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

David Baker-Hargrove, President/Co-CEO
(321) 800-2922

Contract Pharmacy Representative

Publix
Dain Rusk, Vice President
(863) 688-1188

Signed By Date

7/15/2019

340B Drug Pricing Program Database