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SAFESCRIPT PHARMACY
CH040250 PROJECT HEALTH, INC
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Covered Entity Details
Entity Name
PROJECT HEALTH, INC
Subdivision Name
THOMAS E. LANGLEY MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH040250
Entity Address
1389 SOUTH US HIGHWAY 301
SUMTERVILLE, FL 33585
Grant Number
H80CS00412
Participating Start Date
12/1/1992
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
SAFESCRIPT PHARMACY
Pharmacy Address
RISSAN INC
211 N. MARKET ST
BUSHNELL, FL 33513-6021
Pharmacy Comments
Contract Details
Approval Date
10/13/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/11/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Gary Costantino, CFO
(352) 793-5900
Contract Pharmacy Representative
Tej Gandhi
Tejas Gandhi, Owner
(352) 793-8000
Signed By Date
10/13/2014
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