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JTJ MEDICAL SUPPLY, INC
CHC26626-00 FOUNDCARE INC.
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Covered Entity Details
Entity Name
FOUNDCARE INC.
Subdivision Name
FoundCare Health Center
Type
HRSA-Funded Health Center
340B ID
CHC26626-00
Entity Address
2330 S. Congress Avenue
West Palm Beach, FL 33406-7608
Grant Number
H80CS26626
Participating Start Date
4/1/2014
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
JTJ MEDICAL SUPPLY, INC
Pharmacy Address
DBA MAIL MEDS CLINICAL PHARMACY
2692 OAK RIDGE CT
FORT MYERS, FL 33901
Pharmacy Comments
Contract Details
Approval Date
1/14/2014
Contract Begin Date
4/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/29/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Rik Pavlescak, Chief Administrative Officer
(561) 432-7902
Contract Pharmacy Representative
JTJ Medical Supply, Inc.
Mark J. Theobald, Owner
(800) 939-2022 Ext: 111
Signed By Date
1/14/2014
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