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HOLIDAY CVS, L.L.C.
CH04470A Bayou La Batre Area Health Development Board, Inc
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Covered Entity Details
Entity Name
Bayou La Batre Area Health Development Board, Inc
Subdivision Name
SOUTHWEST ALABAMA HEALTH SERVICE
Type
HRSA-Funded Health Center
340B ID
CH04470A
Entity Address
7777 HIGHWAY 43 NORTH
MCINTOSH, AL 36553
Grant Number
H80CS00098
Participating Start Date
7/1/2010
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
CVS PHARMACY # 16620
1749 E NINE MILE RD
PENSACOLA, FL 32514
Pharmacy Comments
Contract Details
Approval Date
10/4/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JAMES A. HOLLAND, CEO
(251) 824-2174 Ext: 5229
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/4/2021
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