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CALLAWAY GULF COAST PHARMACY CO
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
CALLAWAY GULF COAST PHARMACY CO
Pharmacy Address
420 N TYNDALL PARKWAY
PANAMA CITY, FL 32404
Pharmacy Comments
Contract Details
Approval Date
10/17/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/30/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Michael R. Hill, President/CEO
(850) 747-5599
Contract Pharmacy Representative
Meged Shalby, Pharmacist
(850) 615-3000
Signed By Date
10/17/2016
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