Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
HV01312E University of Florida

Covered Entity Details

Entity Name

University of Florida

Subdivision Name

University of Florida CARES CMS

Type

Ryan White Part C

340B ID

HV01312E

Entity Address

910 N. Jefferson St.
Jacksonville, FL 32209

Grant Number

H76HA01312

Participating Start Date

7/1/2019

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

HOLIDAY CVS, L.L.C.

Pharmacy Address

CVS PHARMACY # 17237
463737 STATE RD 200
YULEE, FL 32097

Pharmacy Comments

Contract Details

Approval Date

4/14/2022

Contract Begin Date

4/20/2022

Carve-In Effective Date

Contract Comments

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

4/14/2022

340B Drug Pricing Program Database