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STEVERSON PHARMACY SERVICES, 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
STEVERSON PHARMACY SERVICES, INC
Pharmacy Address
DBA KING DISCOUNT DRUG
1242 MAIN ST
CHIPLEY, FL 32428
Pharmacy Comments
Contract Details
Approval Date
7/28/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/13/2021
Agreement registered in error
Contacts
Covered Entity Signing Official
Michael R. Hill, President/CEO
(850) 747-5599
Contract Pharmacy Representative
William Steverson, Owner
(850) 638-4875
Signed By Date
7/28/2016
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