Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
CH04431AK MCR Health, Inc.

Covered Entity Details

Entity Name

MCR Health, Inc.

Subdivision Name

Riverside MEDICAL SERVICES

Type

HRSA-Funded Health Center

340B ID

CH04431AK

Entity Address

300 Riverside Dr E
Ste 2010
2010
Bradenton, FL 34208-1023

Grant Number

H80CS00097

Participating Start Date

1/1/2016

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

HOLIDAY CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 07938
3724 84TH AVE., CIRCLE EAST
SARASOTA, FL 34243

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