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HOLIDAY CVS, L.L.C.
CHC31892-05 Centerplace Health, Inc.
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Covered Entity Details
Entity Name
Centerplace Health, Inc.
Subdivision Name
CenterPlace Health 17th St Building N
Type
HRSA-Funded Health Center
340B ID
CHC31892-05
Entity Address
1750 17th St BLDG N
Sarasota, FL 34234
Grant Number
H80CS31892
Participating Start Date
4/1/2021
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03258
14998 S. TAMIAMI TRAIL
NORTH PORT, FL 34287
Pharmacy Comments
Contract Details
Approval Date
10/15/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Melissa Jo Parker, Chief Executive Officer
(941) 529-0244
Contract Pharmacy Representative
CVS
Meagan Stevens, Sales Executive
(407) 457-2409
Signed By Date
10/15/2021
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