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HOLIDAY CVS, L.L.C.
CH04170G COLLIER HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
COLLIER HEALTH SERVICES, INC.
Subdivision Name
RONALD MCDONALD CARE MOBILE
Type
HRSA-Funded Health Center
340B ID
CH04170G
Entity Address
1454 Madison Ave W
Immokalee, FL 34142-2200
Grant Number
H80CS00735
Participating Start Date
10/1/2015
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03266
4890 TAMIAMI TR
NAPLES, FL 34112
Pharmacy Comments
Contract Details
Approval Date
10/11/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/11/2023
Agreement registered in error
Contacts
Covered Entity Signing Official
John Fletcher, Chief Operating Officer & General Counsel
(239) 658-3060
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/11/2023
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