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HOLIDAY CVS, L.L.C.
CH04431AQ MCR Health, Inc.
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Covered Entity Details
Entity Name
MCR Health, Inc.
Subdivision Name
Community Care Family Healthcare Center Building B
Type
HRSA-Funded Health Center
340B ID
CH04431AQ
Entity Address
725 N 12th Ave
Arcadia, FL 34266-8752
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 # 03111
945 8TH AVE W
PALMETTO, FL 34221
Pharmacy Comments
Contract Details
Approval Date
1/17/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
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
1/17/2025
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