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HOLIDAY CVS, L.L.C.
CH04550H PREMIER COMMUNITY HEALTHCARE GROUP, INC.
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Covered Entity Details
Entity Name
PREMIER COMMUNITY HEALTHCARE GROUP, INC.
Subdivision Name
Lacoochee Family Health Center
Type
HRSA-Funded Health Center
340B ID
CH04550H
Entity Address
38724 Mudcat Grant Blvd
Dade City, FL 33523
Grant Number
H80CS00101
Participating Start Date
7/1/2015
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03583
12015 LITTLE RD
HUDSON, FL 34667
Pharmacy Comments
Contract Details
Approval Date
7/15/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Joseph Resnick, CEO
(352) 518-2000 Ext: 9000
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/15/2021
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