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JTJ MEDICAL SUPPLY, INC
RWI33713 Metropolitan Charities, Inc.
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Covered Entity Details
Entity Name
Metropolitan Charities, Inc.
Subdivision Name
Type
Ryan White Part A
340B ID
RWI33713
Entity Address
701 94th Avenue North
Suite 250
Saint Petersburg, FL 33702
Grant Number
H89HA00024
Participating Start Date
7/1/2015
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
JTJ MEDICAL SUPPLY, INC
Pharmacy Address
DBA MAIL-MEDS CLINICAL PHARMACY
1125 N NOVA RD
DAYTONA BEACH, FL 32117
Pharmacy Comments
Contract Details
Approval Date
8/28/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/8/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Lorraine Langlois, Chief Executive Officer
(727) 321-3854
Contract Pharmacy Representative
JTJ Medical Supply, Inc.
Mark J. Theobald, Owner
(800) 939-2022 Ext: 111
Signed By Date
8/28/2015
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