340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
HOLIDAY CVS, L.L.C.
CH04168AH FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.
Print
Covered Entity Details
Entity Name
FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.
Subdivision Name
The Salvation Army
Type
HRSA-Funded Health Center
340B ID
CH04168AH
Entity Address
2450 Edison Ave
Fort Myers, FL 33901
Grant Number
H80CS00185
Participating Start Date
7/1/2023
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05785
1209 DEL PRADO BLVD., SOUTH
CAPE CORAL, FL 33990
Pharmacy Comments
Contract Details
Approval Date
1/16/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Carrie Poulsom, VP & Chief Pharmacy Officer
(239) 344-2321
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/16/2024
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session