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JACKSON DRUGS, LLC
CH04037E FLORIDA COMMUNITY HEALTH CENTER INC
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Covered Entity Details
Entity Name
FLORIDA COMMUNITY HEALTH CENTER INC
Subdivision Name
FT. PIERCE COMMUNITY HEALTH CTR
Type
HRSA-Funded Health Center
340B ID
CH04037E
Entity Address
1505 Delaware Ave
Fort Pierce, FL 34950-3975
Grant Number
H80CS00798
Participating Start Date
12/1/1992
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
JACKSON DRUGS, LLC
Pharmacy Address
2301 OKEECHOBEE RD
FORT PIERCE, FL 34950-6554
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Margaret Virginia Russell, VP & CFO
(561) 844-9443 Ext: 1003
Contract Pharmacy Representative
Jackson Drugs, LLC
Kenneth Jackson, Managing Member
(772) 464-3784
Signed By Date
10/16/2023
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