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PUBLIX SUPER MARKETS, INC.
CH045211G FIRST CHOICE PRIMARY CARE, INC.
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Covered Entity Details
Entity Name
FIRST CHOICE PRIMARY CARE, INC.
Subdivision Name
First Choice Primary Care Poplar St
Type
HRSA-Funded Health Center
340B ID
CH045211G
Entity Address
400 Poplar Street
Macon, GA 31201-3336
Grant Number
H80CS08242
Participating Start Date
7/1/2021
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
PUBLIX SUPER MARKETS, INC.
Pharmacy Address
PUBLIX PHARMACY #1233
275 PERRY PKWY
PERRY, GA 31069
Pharmacy Comments
Contract Details
Approval Date
10/15/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Katherine McLeod, CEO
(478) 254-7204
Contract Pharmacy Representative
Publix
Amin Mrugesh, 340B Program Manager
(863) 688-1188 Ext: 52388
Signed By Date
10/15/2024
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