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CCN AMERICA, LP
STD322082 Jacksonville Health and Educational Resource Center, INC
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Covered Entity Details
Entity Name
Jacksonville Health and Educational Resource Center, INC
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD322082
Entity Address
1024 Edgewood Ave W.
Jacksonville, FL 32208
Grant Number
NH25PS005131
Participating Start Date
7/1/2020
Last Recertification Date
5/6/2024
Pharmacy Details
Pharmacy Name
CCN AMERICA, LP
Pharmacy Address
COORDINATED CARE NETWORK PHARMACY
1500 W CYPRESS CREEK RD STE 203
FT LAUDERDALE, FL 33309
Pharmacy Comments
Contract Details
Approval Date
4/15/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lolita D. Hill, CEO
(904) 535-1658
Contract Pharmacy Representative
Coordinated Care Network
Thomas J Pollack, President/CEO
(412) 349-6300
Signed By Date
4/15/2024
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