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HOLIDAY CVS, L.L.C.
CHC31892-00 Centerplace Health, Inc.
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Covered Entity Details
Entity Name
Centerplace Health, Inc.
Subdivision Name
Sally and Sam Shapiro Babies and Children&s Medical Center
Type
HRSA-Funded Health Center
340B ID
CHC31892-00
Entity Address
1750 17th St. BLDG E
Sarasota, FL 34234-8632
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 # 04266
100 US HIGHWAY 41 BYP N
VENICE, FL 34285
Pharmacy Comments
Contract Details
Approval Date
1/15/2021
Contract Begin Date
4/1/2021
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
1/15/2021
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