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HOLIDAY CVS, L.L.C.
CHC31892-02 Centerplace Health, Inc.
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Covered Entity Details
Entity Name
Centerplace Health, Inc.
Subdivision Name
North Port Health Center
Type
HRSA-Funded Health Center
340B ID
CHC31892-02
Entity Address
North Port Health Center
6950 Outreach Way
North Port, FL 34287-3405
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
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