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PUBLIX SUPER MARKETS, INC.
RWI32204 AIDS HEALTHCARE FOUNDATION
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Covered Entity Details
Entity Name
AIDS HEALTHCARE FOUNDATION
Subdivision Name
AHF JACKSONVILLE
Type
Ryan White Part A
340B ID
RWI32204
Entity Address
2 SHIRCLIFF WAY
Suite 900
JACKSONVILLE, FL 32204
Grant Number
H89HA00039
Participating Start Date
7/1/2007
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
PUBLIX SUPER MARKETS, INC.
Pharmacy Address
PUBLIX PHARMACY #0849
2033 RIVERSIDE AVE
JACKSONVILLE, FL 32204
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
Rena DeStefano, Director of Pharmacy Finance
(631) 370-2022
Contract Pharmacy Representative
Publix
Amin Mrugesh, 340B Program Manager
(863) 688-1188 Ext: 52388
Signed By Date
10/15/2024
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