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HOLIDAY CVS, L.L.C.
STD328061 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Orlando
Type
Sexually Transmitted Diseases
340B ID
STD328061
Entity Address
1301 W Colonial Drive
Orlando, FL 32804
Grant Number
1 NH25PS005131-01-00
Participating Start Date
4/5/2019
Last Recertification Date
5/27/2024
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03757
1401 DUTCH ELM DRIVE
ALTAMONTE SPRINGS, FL 32714
Pharmacy Comments
Contract Details
Approval Date
7/26/2021
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
7/26/2021
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