Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
CHC31892-01 Centerplace Health, Inc.

Covered Entity Details

Entity Name

Centerplace Health, Inc.

Subdivision Name

William L. Little Health and Human Services Center

Type

HRSA-Funded Health Center

340B ID

CHC31892-01

Entity Address

2200 Ringling Boulevard
Sarasota, FL 34237-6102

Grant Number

H80CS31892

Participating Start Date

10/1/2018

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

HOLIDAY CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 03258
14998 S. TAMIAMI TRAIL
NORTH PORT, FL 34287

Pharmacy Comments

Contract Details

Approval Date

7/15/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Melissa Jo Parker, Chief Executive Officer
(941) 529-0244

Contract Pharmacy Representative

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

Signed By Date

7/15/2020

340B Drug Pricing Program Database