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PUBLIX SUPER MARKETS, INC.
CH045630 GASTON FAMILY HEALTH SERVICES INC
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Covered Entity Details
Entity Name
GASTON FAMILY HEALTH SERVICES INC
Subdivision Name
Kintegra Family Medicine - Hudson
Type
HRSA-Funded Health Center
340B ID
CH045630
Entity Address
991 W Hudson Blvd
Gastonia, NC 28052-6430
Grant Number
H80CS00293
Participating Start Date
10/1/1997
Last Recertification Date
3/5/2025
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
7/12/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/21/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Robert Spencer, CEO
(704) 616-2245
Contract Pharmacy Representative
Publix Super Markets
Dain Rusk, Vice President Pharmacy
(863) 616-5846
Signed By Date
7/12/2023
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