Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
CH04550B PREMIER COMMUNITY HEALTHCARE GROUP, INC.

Covered Entity Details

Entity Name

PREMIER COMMUNITY HEALTHCARE GROUP, INC.

Subdivision Name

Premier Community Healthcare Group, Inc.- Medical View Lane

Type

HRSA-Funded Health Center

340B ID

CH04550B

Entity Address

6860 Medical View Lane
Zephyrhills, FL 33542

Grant Number

H80CS00101

Participating Start Date

1/1/2003

Last Recertification Date

2/14/2025

Pharmacy Details

Pharmacy Name

HOLIDAY CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 01293
12804 US HWY 301
DADE CITY, FL 33525

Pharmacy Comments

Contract Details

Approval Date

10/15/2019

Contract Begin Date

1/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Joseph Resnick, CEO
(352) 518-2000 Ext: 9000

Contract Pharmacy Representative

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

Signed By Date

10/15/2019

340B Drug Pricing Program Database