Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
CHC26803-01 Neighborhood Medical Center Inc.

Covered Entity Details

Entity Name

Neighborhood Medical Center Inc.

Subdivision Name

Neighborhood Medical Center Smith Williams Center

Type

HRSA-Funded Health Center

340B ID

CHC26803-01

Entity Address

2295 PASCO ST
TALLAHASSEE, FL 32310-0908

Grant Number

H80CS26803

Participating Start Date

7/1/2014

Last Recertification Date

3/7/2025

Pharmacy Details

Pharmacy Name

HOLIDAY CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 03624
1208 W. JEFFERSON ST.
QUINCY, FL 32351

Pharmacy Comments

Contract Details

Approval Date

7/15/2019

Contract Begin Date

10/1/2019

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Jeanne S Freeman, CEO
(850) 577-1558

Contract Pharmacy Representative

Neighborhood Medical Center
Otis W Kirksey, Director of Pharmacy Services
(850) 513-3267

Signed By Date

7/15/2019

340B Drug Pricing Program Database