340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PINE BROOK PHARMACY LLC
CH045500 PREMIER COMMUNITY HEALTHCARE GROUP, INC.
Print
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
PINE BROOK PHARMACY LLC
Pharmacy Address
PINE BROOK PHARMACY #4
11373 CORTEZ BLVD STE 101
BROOKSVILLE, FL 34613-5411
Pharmacy Comments
Contract Details
Approval Date
4/14/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/29/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
Joseph Resnick, CEO
(352) 518-2000 Ext: 9000
Contract Pharmacy Representative
Pinebrook Pharmacy
Gautam Thakkar, Owner
(813) 454-3500
Signed By Date
4/14/2020
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session