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HOLIDAY CVS, L.L.C.
RWI33316H CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Orlando
Type
Ryan White Part A
340B ID
RWI33316H
Entity Address
1301 W Colonial Drive
Orlando, FL 32804
Grant Number
6 UT8HA33952-01-01
Participating Start Date
4/1/2021
Last Recertification Date
3/10/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
CVS PHARMACY # 16311
2575 ENTERPRISE RD
ORANGE CITY, FL 32763
Pharmacy Comments
Contract Details
Approval Date
7/18/2022
Contract Begin Date
10/1/2022
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
7/18/2022
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