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AHSSHC
CH04023F AGAPE COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
AGAPE COMMUNITY HEALTH CENTER, INC.
Subdivision Name
AGAPE/WEST JACKSONVILLE COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH04023F
Entity Address
120 King Street
JACKSONVILLE, FL 32204-2410
Grant Number
H80CS29456
Participating Start Date
4/1/2003
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
AHSSHC
Pharmacy Address
EXPEDIEN RX PHARMACY
5050 WESLEY RD STE 120
APOPKA, FL 32712
Pharmacy Comments
Contract Details
Approval Date
10/16/2017
Contract Begin Date
10/11/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2021
Agreement registered in error
Contacts
Covered Entity Signing Official
Mia Jones, CEO
(904) 703-0165
Contract Pharmacy Representative
Agape
Trenia Yielding, Executive Director
(407) 357-2601
Signed By Date
10/16/2017
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