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HOLIDAY CVS, L.L.C.
CH04037P FLORIDA COMMUNITY HEALTH CENTER INC
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Covered Entity Details
Entity Name
FLORIDA COMMUNITY HEALTH CENTER INC
Subdivision Name
Florida Community Health Center - Darwin Square
Type
HRSA-Funded Health Center
340B ID
CH04037P
Entity Address
3235 SW PORT ST LUCIE BLVD UNIT #105
PORT ST LUCIE, FL 34953-3406
Grant Number
H80CS00798
Participating Start Date
4/1/2016
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 07923
2873 SW PORT ST. LUCIE BLVD.
PORT SAINT LUCIE, FL 34953
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Margaret Virginia Russell, VP & CFO
(561) 844-9443 Ext: 1003
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/16/2023
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