Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
STD344712 26Health, Inc.

Covered Entity Details

Entity Name

26Health, Inc.

Subdivision Name

Ocala Infectious Disease and Wound Clinic

Type

Sexually Transmitted Diseases

340B ID

STD344712

Entity Address

2651 SW 32nd PL
Ocala, FL 34471

Grant Number

1H25PS00432-02

Participating Start Date

7/1/2018

Last Recertification Date

5/4/2020

Entity Termination Date

1/1/2021

Pharmacy Details

Pharmacy Name

HOLIDAY CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 03661
2401 SW 27TH AVE.
OCALA, FL 34471

Pharmacy Comments

Contract Details

Approval Date

7/13/2018

Contract Begin Date

10/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/8/2018
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

David Baker-Hargrove, President/Co-CEO
(321) 800-2922

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

7/13/2018

340B Drug Pricing Program Database