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JTJ MEDICAL SUPPLY, INC
FQHCLA407D Metropolitan Charities, Inc.
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Covered Entity Details
Entity Name
Metropolitan Charities, Inc.
Subdivision Name
METRO Central
Type
Health Center Program Look-Alike
340B ID
FQHCLA407D
Entity Address
2237 Central Ave
Saint Petersburg, FL 33713-8844
Grant Number
LALCS35348
Participating Start Date
8/4/2021
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
JTJ MEDICAL SUPPLY, INC
Pharmacy Address
DBA MAIL MEDS CLINICAL PHARMACY
2692 OAK RIDGE CT
FORT MYERS, FL 33901
Pharmacy Comments
Contract Details
Approval Date
8/4/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Priya Rajkumar, Chief Executive Officer
(727) 321-3854 Ext: 1230
Contract Pharmacy Representative
JTJ Medical Supply, Inc.
Mark J. Theobald, Owner
(800) 939-2022 Ext: 111
Signed By Date
8/3/2021
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