Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
CH040370 FLORIDA CHC'S, INC.

Covered Entity Details

Entity Name

FLORIDA CHC'S, INC.

Subdivision Name

Type

HRSA-Funded Health Center

340B ID

CH040370

Entity Address

5827 CORPORATE WAY
WEST PALM BEACH, FL 33407

Grant Number

H80CS00798

Participating Start Date

12/1/1992

Last Recertification Date

2/13/2025

Pharmacy Details

Pharmacy Name

HOLIDAY CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 00111
1891 N. US HWY 1
FORT PIERCE, FL 34946

Pharmacy Comments

Contract Details

Approval Date

1/13/2017

Contract Begin Date

4/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/13/2018
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

KATHY AMATO, VICE PRESIDENT & CFO
(561) 844-9443 Ext: 311

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

1/13/2017

340B Drug Pricing Program Database