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HOLIDAY CVS, L.L.C.
CH04172P CENTRAL FLORIDA FAMILY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
CENTRAL FLORIDA FAMILY HEALTH CENTER, INC.
Subdivision Name
Enterprise Wellness Cottage
Type
HRSA-Funded Health Center
340B ID
CH04172P
Entity Address
105 Main Street
Enterprise, FL 32725
Grant Number
H80CS00178
Participating Start Date
10/1/2024
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 00204
5899 ORANGE BLOSSOM TRL
ORLANDO, FL 32839
Pharmacy Comments
Contract Details
Approval Date
10/15/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Janelle A Dunn, CEO
(407) 322-8645 Ext: 1132
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2024
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