Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
CH04166Z Community Health Centers, Inc.

Covered Entity Details

Entity Name

Community Health Centers, Inc.

Subdivision Name

Community Health Centers Clermont

Type

HRSA-Funded Health Center

340B ID

CH04166Z

Entity Address

2140 N Don Wickham Dr. Suite C
Clermont, FL 34711-1923

Grant Number

H80CS00809

Participating Start Date

7/1/2018

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

HOLIDAY CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 04238
1612 E SILVER STAR RD
OCOEE, FL 34761

Pharmacy Comments

Contract Details

Approval Date

4/15/2025

Contract Begin Date

7/1/2025

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Debra Sue Andree, President / Chief Executive Officer
(407) 905-8827 Ext: 1212

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

4/15/2025

340B Drug Pricing Program Database