Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
CHC11399-00 Care Resource Community Health Centers, Inc.

Covered Entity Details

Entity Name

Care Resource Community Health Centers, Inc.

Subdivision Name

Care Resource Community Health Center at Ft. Lauderdale

Type

HRSA-Funded Health Center

340B ID

CHC11399-00

Entity Address

871 W Oakland Park Blvd
Wilton Manors, FL 33311-1731

Grant Number

H80CS12864

Participating Start Date

7/1/2009

Last Recertification Date

2/21/2025

Pharmacy Details

Pharmacy Name

HOLIDAY CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 04222
4400 HOLLYWOOD BLVD
HOLLYWOOD, FL 33021

Pharmacy Comments

Contract Details

Approval Date

4/12/2021

Contract Begin Date

7/1/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

3/13/2023
Pharmacy closed

Contacts

Covered Entity Signing Official

Rick Siclari, Chief Executive Officer
(305) 576-1234 Ext: 206

Contract Pharmacy Representative

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

Signed By Date

4/12/2021

340B Drug Pricing Program Database