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HOLIDAY CVS, L.L.C.
STD32547 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
FWB
Type
Sexually Transmitted Diseases
340B ID
STD32547
Entity Address
1825 Hurlburt Rd
Suite 14
Fort Walton Beach, FL 32547
Grant Number
1 NH25PS005131-01-00
Participating Start Date
1/1/2020
Last Recertification Date
5/27/2024
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05194
1081 BEAL PKWY NW
FORT WALTON BEACH, FL 32547
Pharmacy Comments
Contract Details
Approval Date
10/12/2021
Contract Begin Date
1/1/2022
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
10/12/2021
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