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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 # 03204
5010 S FLORIDA AVE
LAKELAND, FL 33813
Pharmacy Comments
Contract Details
Approval Date
7/13/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/13/2020
Agreement registered in error
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
7/13/2020
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