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AVENUE PHARMACY INC.
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
AVENUE PHARMACY INC.
Pharmacy Address
DBA PATHWAY PHARMACY
202 SW 17TH ST
SUITE A
OCALA, FL 34471-8138
Pharmacy Comments
Contract Details
Approval Date
1/2/2015
Contract Begin Date
4/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Gary Costantino, CFO
(352) 793-5900
Contract Pharmacy Representative
Oswald Cornelio, Owner
(352) 624-2779
Signed By Date
1/2/2015
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