Contract Pharmacy Details

HEALTHSMART DISCOUNT PHARMACY
CH04038Z NORTH FLORIDA MEDICAL CENTERS, INC.

Covered Entity Details

Entity Name

NORTH FLORIDA MEDICAL CENTERS, INC.

Subdivision Name

Baker Family Medical Center

Type

HRSA-Funded Health Center

340B ID

CH04038Z

Entity Address

1321 Georgia Ave
Baker, FL 32531-2605

Grant Number

H80CS00693

Participating Start Date

4/1/2009

Last Recertification Date

2/13/2017

Entity Termination Date

4/1/2017

Pharmacy Details

Pharmacy Name

HEALTHSMART DISCOUNT PHARMACY

Pharmacy Address

HEALTH SMART PHARMACY, INC.
5809 HIGHWAY 189 N
BAKER, FL 32531-2501

Pharmacy Comments

Contract Details

Approval Date

4/1/2009

Contract Begin Date

4/1/2009

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2017

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Signed By Date

3/6/2009

340B Drug Pricing Program Database