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JACKSON DRUGS, LLC
CH04037T FLORIDA COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
FLORIDA COMMUNITY HEALTH CENTER
Subdivision Name
Florida Community Health Centers, Inc. - Grace Women and Children
Type
HRSA-Funded Health Center
340B ID
CH04037T
Entity Address
714 Avenue C
Fort Pierce, FL 34950-4189
Grant Number
H80CS00798
Participating Start Date
1/19/2023
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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