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HOLIDAY CVS, L.L.C.
STD33544 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Wesley Chapel
Type
Sexually Transmitted Diseases
340B ID
STD33544
Entity Address
5504 Gateway Blvd
Wesley Chapel, FL 33544
Grant Number
1 NH25PS005131-01-00
Participating Start Date
4/1/2016
Last Recertification Date
5/27/2024
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05196
11670 COUNTRYWAY BLVD
TAMPA, FL 33626
Pharmacy Comments
Contract Details
Approval Date
4/13/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/19/2023
Pharmacy closed
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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