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NORTH FLORIDA PHARMACY 0F FORT WHITE INC
CH04271B TRENTON MEDICAL CENTER
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Covered Entity Details
Entity Name
TRENTON MEDICAL CENTER
Subdivision Name
Palms Medical Group - Bell
Type
HRSA-Funded Health Center
340B ID
CH04271B
Entity Address
1830 N Main St
Bell, FL 32619-4713
Grant Number
H80CS00691
Participating Start Date
10/1/2002
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
NORTH FLORIDA PHARMACY 0F FORT WHITE INC
Pharmacy Address
7729 SW US HIGHWAY 27
FORT WHITE, FL 32038-3508
Pharmacy Comments
Contract Details
Approval Date
1/16/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Anita Rembert, CEO
(352) 463-4501
Contract Pharmacy Representative
North Florida Pharmacy
Joel Rosenfeld, Pharmacist
(352) 490-7700
Signed By Date
1/16/2024
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