Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
RWII32606 North Central Florida Health Planning Council dba WellFlorida Council

Covered Entity Details

Entity Name

North Central Florida Health Planning Council dba WellFlorida Council

Subdivision Name

WellFlorida Council

Type

Ryan White Part B

340B ID

RWII32606

Entity Address

1785 NW 80th Blvd
Gainesville, FL 32606

Grant Number

X07HA00057

Participating Start Date

7/1/2021

Last Recertification Date

2/3/2023

Entity Termination Date

7/1/2023

Pharmacy Details

Pharmacy Name

HOLIDAY CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 02188
209 S TEMPLE ST
STARKE, FL 32091

Pharmacy Comments

Contract Details

Approval Date

5/5/2021

Contract Begin Date

7/1/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2023
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Jeffrey Allen Feller, Chief Executive Officer
(352) 214-2164

Contract Pharmacy Representative

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

Signed By Date

4/1/2021

340B Drug Pricing Program Database