Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
STD33334 CAN Community Health, Inc.

Covered Entity Details

Entity Name

CAN Community Health, Inc.

Subdivision Name

Oakland Park

Type

Sexually Transmitted Diseases

340B ID

STD33334

Entity Address

1421 E Oakland Park Blvd
Suite 200
Fort Lauderdale, FL 33334

Grant Number

1 NH25PS005131-01-00

Participating Start Date

7/1/2017

Last Recertification Date

5/27/2024

Pharmacy Details

Pharmacy Name

HOLIDAY CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 05929
10004 W. MCNAB RD.
TAMARAC, FL 33321

Pharmacy Comments

Contract Details

Approval Date

7/16/2023

Contract Begin Date

10/1/2023

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

7/16/2023

340B Drug Pricing Program Database