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JTJ MEDICAL SUPPLY, INC
STD328062 Bliss Cares
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Covered Entity Details
Entity Name
Bliss Cares
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD328062
Entity Address
3901 E Colonial Drive
ORLANDO, FL 32803
Grant Number
NH25PS005131
Participating Start Date
7/1/2016
Last Recertification Date
5/7/2024
Pharmacy Details
Pharmacy Name
JTJ MEDICAL SUPPLY, INC
Pharmacy Address
DBA MAIL-MEDS CLINICAL PHARMACY
1301 W COLONIAL DR STE 102
ORLANDO, FL 32804
Pharmacy Comments
Contract Details
Approval Date
7/14/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/24/2020
Pharmacy closed
Contacts
Covered Entity Signing Official
Lekisha Cohen, Registered Nurse Consultant
(850) 245-4324
Contract Pharmacy Representative
JTJ Medical Supply, Inc.
Mark J. Theobald, Owner
(800) 939-2022 Ext: 111
Signed By Date
7/14/2016
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