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HOLIDAY CVS, L.L.C.
CH04025J PROJECT HEALTH INC
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Covered Entity Details
Entity Name
PROJECT HEALTH INC
Subdivision Name
Lecanto Multi Purpose Site
Type
HRSA-Funded Health Center
340B ID
CH04025J
Entity Address
595 N Lecanto Hwy
Lecanto, FL 34461-9187
Grant Number
H80CS00412
Participating Start Date
7/1/2020
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05231
7563 SE MARICAMP RD
OCALA, FL 34472
Pharmacy Comments
Contract Details
Approval Date
10/13/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John M. Sivon, Chief Strategy Officer
(352) 569-2386
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/13/2023
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