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HOLIDAY CVS, L.L.C.
STD33334 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Oakland Park
Type
Sexually Transmitted Diseases
340B ID
STD33334
Entity Address
1421 E Oakland Park Blvd
Suite 200
Fort Lauderdale, FL 33334
Grant Number
1 NH25PS005131-01-00
Participating Start Date
7/1/2017
Last Recertification Date
5/27/2024
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05897
3700 NW 199TH ST.
MIAMI GARDENS, FL 33055
Pharmacy Comments
Contract Details
Approval Date
10/15/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard E. Carlisle, President & CEO
(941) 366-0134 Ext: 11111
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2020
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