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PUBLIX SUPER MARKETS, INC.
STD331391 PREVENTION 305
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Covered Entity Details
Entity Name
PREVENTION 305
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD331391
Entity Address
407 Lincoln Road, Suite 6D
MIAMI BEACH, FL 33139
Grant Number
NH25PS005131
Participating Start Date
5/8/2020
Last Recertification Date
5/9/2025
Pharmacy Details
Pharmacy Name
PUBLIX SUPER MARKETS, INC.
Pharmacy Address
2424 ORLANDO CENTRAL PKWY STE 100
PUBLIX CENTRAL PHARMACY #3201
ORLANDO, FL 32809
Pharmacy Comments
Contract Details
Approval Date
1/15/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Patrick Whiteside, Chief Executive Officer
(866) 773-7305 Ext: 100
Contract Pharmacy Representative
Publix
Dain Rusk, Vice President
(863) 688-1188
Signed By Date
1/15/2025
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