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AIDS HEALTHCARE FOUNDATION
FQHCLA330 BOND COMMUNITY HEALTH CENTER INC
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Covered Entity Details
Entity Name
BOND COMMUNITY HEALTH CENTER INC
Subdivision Name
Bond Community Health Center (Main Site)
Type
Health Center Program Look-Alike
340B ID
FQHCLA330
Entity Address
1720 S. Gadsden Street
Tallahassee, FL 32301-5506
Grant Number
LALCS00163
Participating Start Date
1/1/2015
Last Recertification Date
2/10/2015
Entity Termination Date
1/1/2016
Pharmacy Details
Pharmacy Name
AIDS HEALTHCARE FOUNDATION
Pharmacy Address
AHF PHARMACY
2 SHIRCLIFF WAY STE 900
DE PAUL BUILDING
JACKSONVILLE, FL 32204-4753
Pharmacy Comments
Contract Details
Approval Date
10/29/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2016
Contacts
Covered Entity Signing Official
Bernard Goodman, CEO
(850) 576-4073 Ext: 205
Contract Pharmacy Representative
aidshealth
SCOTT CARRUTHERS, SR. MANAGER, CHIEF PHARMACY OFFICER
(323) 860-5200 Ext: 5266
Signed By Date
10/29/2014
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