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PUBLIX SUPER MARKETS, INC.
CH042710 TRENTON MEDICAL CENTER
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Covered Entity Details
Entity Name
TRENTON MEDICAL CENTER
Subdivision Name
Palms Medical Group - Trenton
Type
HRSA-Funded Health Center
340B ID
CH042710
Entity Address
911 South Main street
Trenton, FL 32693
Grant Number
H80CS00691
Participating Start Date
10/1/1997
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
PUBLIX SUPER MARKETS, INC.
Pharmacy Address
PUBLIX PHARMACY #1709
2215 OHIO AVE N
LIVE OAK, FL 32064
Pharmacy Comments
Contract Details
Approval Date
7/11/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Anita Rembert, CEO
(352) 463-4501
Contract Pharmacy Representative
Publix
Amin Mrugesh, 340B Program Manager
(863) 688-1188 Ext: 52388
Signed By Date
7/11/2023
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