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HOLIDAY CVS, L.L.C.
RW400091 University of Florida
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Covered Entity Details
Entity Name
University of Florida
Subdivision Name
University of Florida CARES Rainbow
Type
Ryan White Part D
340B ID
RW400091
Entity Address
655 W. 8th Street 3rd FL
Jacksonville, FL 32209
Grant Number
H12HA24824
Participating Start Date
4/1/2014
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05004
5634 MERRILL RD.
JACKSONVILLE, FL 32277
Pharmacy Comments
Contract Details
Approval Date
4/1/2022
Contract Begin Date
4/21/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/30/2025
Pharmacy closed
Contacts
Covered Entity Signing Official
Tina M. Bottini, Senior Asst. Dean, Research
(904) 244-9478
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/1/2022
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