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PUBLIX SUPER MARKETS
CH04168D FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.
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Covered Entity Details
Entity Name
FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.
Subdivision Name
FORT MYERS CENTER - DOWNTOWN
Type
HRSA-Funded Health Center
340B ID
CH04168D
Entity Address
2232 GRAND AVE
FORT MYERS, FL 33901-3717
Grant Number
H80CS00185
Participating Start Date
4/1/1995
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
PUBLIX SUPER MARKETS
Pharmacy Address
PUBLIX PHARMACY #0162
5781 LEE BLVD
LEHIGH ACRES, FL 33971-6337
Pharmacy Comments
Contract Details
Approval Date
7/11/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Carrie Poulsom, VP & Chief Pharmacy Officer
(239) 344-2321
Contract Pharmacy Representative
Publix
Amin Mrugesh, 340B Program Manager
(863) 688-1188 Ext: 52388
Signed By Date
7/11/2024
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