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JTJ MEDICAL SUPPLY, INC.
RWII32301 Big Bend Cares Inc.
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Covered Entity Details
Entity Name
Big Bend Cares Inc.
Subdivision Name
Type
Ryan White Part B
340B ID
RWII32301
Entity Address
2201 South Monroe Street
Tallahassee, FL 32301
Grant Number
X07HA00057
Participating Start Date
7/1/2013
Last Recertification Date
2/4/2019
Entity Termination Date
4/1/2019
Pharmacy Details
Pharmacy Name
JTJ MEDICAL SUPPLY, INC.
Pharmacy Address
DBA MAIL-MEDS CLINICAL PHARMACY
2200 S MONROE ST
SUITE 201
TALLAHASSEE, FL 32301-6303
Pharmacy Comments
Contract Details
Approval Date
4/3/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Robert Renzi, CEO
(850) 656-2437 Ext: 240
Contract Pharmacy Representative
JTJ Medical Supply, Inc.
Mark J. Theobald, Owner
(800) 939-2022 Ext: 111
Signed By Date
4/3/2018
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