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NORTH FLORIDA PHARMACY OF MADISON INC.
CH04038AB NORTH FLORIDA MEDICAL CENTERS, INC.
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Covered Entity Details
Entity Name
NORTH FLORIDA MEDICAL CENTERS, INC.
Subdivision Name
Madison Medical Center
Type
HRSA-Funded Health Center
340B ID
CH04038AB
Entity Address
235 SW DADE ST
MADISON, FL 32340-2363
Grant Number
H80CS00693
Participating Start Date
1/1/2015
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
NORTH FLORIDA PHARMACY OF MADISON INC.
Pharmacy Address
139 SW MACON ST
MADISON, FL 32340
Pharmacy Comments
Contract Details
Approval Date
5/16/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tori Wiggins, CFO
(850) 298-6040
Contract Pharmacy Representative
North Florida Pharmacy of Madison
LINDA BEZICK, PHARMACY MANAGER
(850) 973-8120
Signed By Date
5/16/2024
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