Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
CH04037R Florida Community Health Centers, Inc.

Covered Entity Details

Entity Name

Florida Community Health Centers, Inc.

Subdivision Name

Florida Community Health Centers, Inc. Mobile Unit 1

Type

HRSA-Funded Health Center

340B ID

CH04037R

Entity Address

9576 S US Highway 1
Port St Lucie, FL 34952-4217

Grant Number

H80CS00798

Participating Start Date

9/8/2021

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

340B Drug Pricing Program Database