Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
CH04431U MCR Health, Inc.

Covered Entity Details

Entity Name

MCR Health, Inc.

Subdivision Name

MYAKKA CITY FAMILY MEDICAL CTR

Type

HRSA-Funded Health Center

340B ID

CH04431U

Entity Address

37220 GLENWOOD AVE
MYAKKA CITY, FL 34251-4251

Grant Number

H80CS00097

Participating Start Date

4/1/2013

Last Recertification Date

2/20/2024

Entity Termination Date

4/1/2025

Pharmacy Details

Pharmacy Name

HOLIDAY CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 05859
3813 MANATEE AVE. WEST
BRADENTON, FL 34205

Pharmacy Comments

Contract Details

Approval Date

7/15/2024

Contract Begin Date

10/1/2024

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

MONICA RIDER, Chief Medical Officer
(941) 999-0310

Contract Pharmacy Representative

Montana CVS Pharmacy, LLC
Christian Reid, Senior Director
(401) 770-2118

Signed By Date

7/15/2024

340B Drug Pricing Program Database