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JTJ MEDICAL SUPPLY, INC.
CH0442450 PANCARE OF FLORIDA INC
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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
JTJ MEDICAL SUPPLY, INC.
Pharmacy Address
DBA MAIL-MEDS CLINICAL PHARMACY
2200 S MONROE ST
SUITE 201
TALLAHASSEE, FL 32301-6303
Pharmacy Comments
Contract Details
Approval Date
10/15/2019
Contract Begin Date
1/1/2020
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
JTJ Medical Supply, Inc.
Mark J. Theobald, Owner
(800) 939-2022 Ext: 111
Signed By Date
10/15/2019
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