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HOLIDAY CVS, L.L.C.
CH041750 SUNCOAST COMMUNITY HEALTH CENTERS, INC.
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Covered Entity Details
Entity Name
SUNCOAST COMMUNITY HEALTH CENTERS, INC.
Subdivision Name
SUNCOAST COMMUNITY HEALTH CENTERS, INC.
Type
HRSA-Funded Health Center
340B ID
CH041750
Entity Address
820 15th ST SE
Ruskin, FL 33570
Grant Number
H80CS00541
Participating Start Date
12/1/1992
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 00613
9202 N FLORIDA AVE
TAMPA, FL 33612
Pharmacy Comments
Contract Details
Approval Date
10/14/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/11/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Bradley Herremans, CEO
(813) 653-6268
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/14/2019
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