340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PICH KTM CORP
STD322063 Community Rehabilitation Center, Inc
Print
Covered Entity Details
Entity Name
Community Rehabilitation Center, Inc
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD322063
Entity Address
623 Beechwood Street
Jacksonville, FL 32206
Grant Number
NH25PS005131
Participating Start Date
7/1/2021
Last Recertification Date
5/7/2024
Pharmacy Details
Pharmacy Name
PICH KTM CORP
Pharmacy Address
DBA MEDTOWN PHARMACY
11643 BEACH BLVD
UNIT A
JACKSONVILLE, FL 32246
Pharmacy Comments
Contract Details
Approval Date
10/14/2021
Contract Begin Date
11/9/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Erakal Goodman, Director of Grants and Special Programs
(904) 358-1211
Contract Pharmacy Representative
Medtown Pharmacy
Nakry Oeur, Owner
(904) 551-5870
Signed By Date
10/14/2021
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