Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
CHC31892-04 Centerplace Health, Inc.

Covered Entity Details

Entity Name

Centerplace Health, Inc.

Subdivision Name

Venice Family Services

Type

HRSA-Funded Health Center

340B ID

CHC31892-04

Entity Address

2350 Scenic Dr
Venice, FL 34293-1510

Grant Number

H80CS31892

Participating Start Date

4/1/2021

Last Recertification Date

1/31/2024

Entity Termination Date

4/1/2025

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

1/19/2021

Contract Begin Date

4/1/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2025
Covered Entity Terminated

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

340B Drug Pricing Program Database