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HOLIDAY CVS, L.L.C.
STD33990 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Cape Coral
Type
Sexually Transmitted Diseases
340B ID
STD33990
Entity Address
1224 Del Prado Blvd. S.
Suite A
Cape Coral, FL 33990-3670
Grant Number
NU62PS924532
Participating Start Date
1/1/2022
Last Recertification Date
5/27/2024
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05785
1209 DEL PRADO BLVD., SOUTH
CAPE CORAL, FL 33990
Pharmacy Comments
Contract Details
Approval Date
4/13/2022
Contract Begin Date
7/1/2022
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
4/13/2022
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