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HOLIDAY CVS, L.L.C.
STD33511 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Brandon
Type
Sexually Transmitted Diseases
340B ID
STD33511
Entity Address
214 Morrison Road, Suite 104
Brandon, FL 33511
Grant Number
1 NH25PS005131-01-00
Participating Start Date
1/1/2016
Last Recertification Date
5/27/2024
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03638
10623 GIBSONTON DR
RIVERVIEW, FL 33578
Pharmacy Comments
Contract Details
Approval Date
7/25/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rishi Patel, President & CEO
(941) 300-4440 Ext: 11127
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/25/2021
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