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JTJ MEDICAL SUPPLY, INC
RWI33316H CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Orlando
Type
Ryan White Part A
340B ID
RWI33316H
Entity Address
1301 W Colonial Drive
Orlando, FL 32804
Grant Number
6 UT8HA33952-01-01
Participating Start Date
4/1/2021
Last Recertification Date
3/10/2025
Pharmacy Details
Pharmacy Name
JTJ MEDICAL SUPPLY, INC
Pharmacy Address
DBA MAIL-MEDS CLINICAL PHARMACY
1301 W COLONIAL DR STE 102
ORLANDO, FL 32804
Pharmacy Comments
Contract Details
Approval Date
3/9/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/28/2025
Ownership change
Contacts
Covered Entity Signing Official
Richard E. Carlisle, President & CEO
(941) 366-0134 Ext: 11111
Contract Pharmacy Representative
JTJ Medical Supply, Inc.
Mark J. Theobald, Owner
(800) 939-2022 Ext: 111
Signed By Date
1/15/2021
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