Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
RWII342371K CAN Community Health, Inc.

Covered Entity Details

Entity Name

CAN Community Health, Inc.

Subdivision Name

Pensacola

Type

Ryan White Part B

340B ID

RWII342371K

Entity Address

8390 N Palafox St.
Pensacola, FL 32534

Grant Number

X07HA00057

Participating Start Date

7/1/2020

Last Recertification Date

3/3/2025

Pharmacy Details

Pharmacy Name

HOLIDAY CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 04430
44 GULF BEACH HWY
PENSACOLA, FL 32507

Pharmacy Comments

Contract Details

Approval Date

4/15/2021

Contract Begin Date

7/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Richard E. Carlisle, President & CEO
(941) 366-0134 Ext: 11111

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

4/15/2021

340B Drug Pricing Program Database