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PUBLIX SUPER MARKETS, INC.
CH045500 PREMIER COMMUNITY HEALTHCARE GROUP, INC.
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Covered Entity Details
Entity Name
PREMIER COMMUNITY HEALTHCARE GROUP, INC.
Subdivision Name
Dade City Dental Center
Type
HRSA-Funded Health Center
340B ID
CH045500
Entity Address
37944 Pasco Ave
Dade City, FL 33525-4207
Grant Number
H80CS00101
Participating Start Date
4/1/1998
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
PUBLIX SUPER MARKETS, INC.
Pharmacy Address
PUBLIX PHARMACY #1496
11830 US HWY 301
DADE CITY, FL 33525
Pharmacy Comments
Contract Details
Approval Date
1/14/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/23/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Joseph Resnick, CEO
(352) 518-2000 Ext: 9000
Contract Pharmacy Representative
Publix Super Markets
Dain Rusk, Vice President Pharmacy
(863) 616-5846
Signed By Date
1/14/2020
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