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H&R PHARMACY
CH042377B NORTHEAST FLORIDA HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
NORTHEAST FLORIDA HEALTH SERVICES, INC.
Subdivision Name
DBA DELTONA MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH042377B
Entity Address
2160 HOWLAND BLVD
DELTONA, FL 32718-3467
Grant Number
H80CS02520
Participating Start Date
1/1/2009
Last Recertification Date
2/3/2021
Entity Termination Date
4/1/2022
Pharmacy Details
Pharmacy Name
H&R PHARMACY
Pharmacy Address
HR RX LLC
870 SAXON BLVD STE 45
ORANGE CITY, FL 32763-8209
Pharmacy Comments
Contract Details
Approval Date
1/20/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/18/2018
Agreement registered in error
Contacts
Covered Entity Signing Official
Debbie Hall, Director of Operations
(386) 202-6025 Ext: 2705
Contract Pharmacy Representative
HR RX LLC
Hany Badawy, Rph/owner
(386) 218-0926
Signed By Date
1/20/2017
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