340B Drug Pricing Program Database
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PUBLIX SUPER MARKETS, INC.
CH04094BN Blue Ridge Community Health Services, Inc.
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Covered Entity Details
Entity Name
Blue Ridge Community Health Services, Inc.
Subdivision Name
Pardee BlueMD 1824 Pisgah Drive
Type
HRSA-Funded Health Center
340B ID
CH04094BN
Entity Address
1824 Pisgah Drive
Hendersonville, NC 28791-3579
Grant Number
H80CS00650
Participating Start Date
9/13/2022
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
PUBLIX SUPER MARKETS, INC.
Pharmacy Address
PUBLIX PHARMACY #3213
1950 SAND LAKE RD, BLDG #5
ORLANDO, FL 32809
Pharmacy Comments
Contract Details
Approval Date
3/2/2023
Contract Begin Date
3/2/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/13/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Michael Sunday, VP Finance, CFO
(828) 696-1175
Contract Pharmacy Representative
Publix
Amin Mrugesh, 340B Program Manager
(863) 688-1188 Ext: 52388
Signed By Date
3/2/2023
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