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HOLIDAY CVS, L.L.C.
CHC31892-01 Centerplace Health, Inc.
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Covered Entity Details
Entity Name
Centerplace Health, Inc.
Subdivision Name
William L. Little Health and Human Services Center
Type
HRSA-Funded Health Center
340B ID
CHC31892-01
Entity Address
2200 Ringling Boulevard
Sarasota, FL 34237-6102
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 # 03122
2480 TAMIAMI TRL
PORT CHARLOTTE, FL 33952
Pharmacy Comments
Contract Details
Approval Date
7/13/2021
Contract Begin Date
10/1/2021
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
7/13/2021
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