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BALLS REXALL DRUGS 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
BALLS REXALL DRUGS INC
Pharmacy Address
DBA B&W REXALL DRUGS
500 STATE ROAD 436 STE 2074
CASSELBERRY, FL 32707
Pharmacy Comments
Contract Details
Approval Date
7/11/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Gary Costantino, CFO
(352) 793-5900
Contract Pharmacy Representative
Ken Heimann, PiC
(352) 726-1021
Signed By Date
7/11/2017
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