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HOLIDAY CVS, L.L.C.
RWII32117 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Daytona
Type
Ryan White Part B
340B ID
RWII32117
Entity Address
1125 N. Nova Rd.
Daytona Beach, FL 32117
Grant Number
X07HA00057
Participating Start Date
7/1/2014
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 00214
901 N WOODLAND BLVD
DELAND, FL 32720
Pharmacy Comments
Contract Details
Approval Date
1/12/2022
Contract Begin Date
4/1/2022
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
1/12/2022
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