Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
RW400091E University of Florida

Covered Entity Details

Entity Name

University of Florida

Subdivision Name

UF Health Women's Specialist-Jacksonville

Type

Ryan White Part D

340B ID

RW400091E

Entity Address

655 W. 8th Street 3rd Fl ACC Bldg.
Jacksonville, FL 32209

Grant Number

H12HA24824

Participating Start Date

10/1/2023

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

8/1/2023

Contract Begin Date

10/1/2023

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

7/7/2023

340B Drug Pricing Program Database