340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
HOLIDAY CVS, L.L.C.
DSH100025 SACRED HEART HEALTH SYSTEM
Print
Covered Entity Details
Entity Name
SACRED HEART HEALTH SYSTEM
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH100025
Entity Address
5151 NORTH 9TH AVENUE
PENSACOLA, FL 32504
Medicare Provider Number
100025
Participating Start Date
7/1/2003
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 04177
2100 WEST CERVANTES
PENSACOLA, FL 32505
Pharmacy Comments
Contract Details
Approval Date
7/7/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/15/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Henry Stovall, President
(850) 416-7681
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/7/2017
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