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WINN DIXIE STORES, INC.
CH0442450 PANCARE OF FLORIDA INC
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Covered Entity Details
Entity Name
PANCARE OF FLORIDA INC
Subdivision Name
DBA CHC-BAY COUNTY
Type
HRSA-Funded Health Center
340B ID
CH0442450
Entity Address
403 EAST 11th STREET
PANAMA CITY, FL 32401
Grant Number
H80CS06452
Participating Start Date
7/1/2006
Last Recertification Date
2/3/2022
Entity Termination Date
10/1/2022
Pharmacy Details
Pharmacy Name
WINN DIXIE STORES, INC.
Pharmacy Address
WINN DIXIE PHARMACY # 481
3621 US HWY 231 NORTH
PANAMA CITY, FL 32404
Pharmacy Comments
Contract Details
Approval Date
4/15/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/1/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Michael R. Hill, President/CEO
(850) 747-5599
Contract Pharmacy Representative
John Fegan, VP of Pharmacy
(904) 783-5000
Signed By Date
4/15/2016
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