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MEDWINS PHARMACY INC
HV33830B FDOH Polk
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Covered Entity Details
Entity Name
FDOH Polk
Subdivision Name
Lakeland satellite clinic
Type
Ryan White Part C
340B ID
HV33830B
Entity Address
3241 Lakeland Hills Blvd
Lakeland, FL 33805
Grant Number
H76HA00596
Participating Start Date
4/1/2016
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
MEDWINS PHARMACY INC
Pharmacy Address
CENTRAL PHARMACY
740 W MAIN ST UNIT 5
BUILDING 1
HAINES CITY, FL 33844
Pharmacy Comments
Contract Details
Approval Date
4/13/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Joy Jackson, Director
(863) 578-2101
Contract Pharmacy Representative
Central Pharmacy
Abish Thomas, PharmD.
(863) 419-7777
Signed By Date
4/13/2020
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