340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PICH KTM CORP
STD322023 FIRST COAST COMMUNITY DEVELOPMENT, INC
Print
Covered Entity Details
Entity Name
FIRST COAST COMMUNITY DEVELOPMENT, INC
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD322023
Entity Address
525 N. Newnan Street
Jacksonville, FL 32202
Grant Number
6NU62PS924532-05-01
Participating Start Date
5/25/2022
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
7/25/2022
Contract Begin Date
7/25/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/21/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Charlie Bernard Griffin, Executive Director
(904) 866-7483
Contract Pharmacy Representative
Medtown Pharmacy
Nakry Oeur, Owner
(904) 551-5870
Signed By Date
7/25/2022
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