Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
CH04166X Community Health Centers, Inc.

Covered Entity Details

Entity Name

Community Health Centers, Inc.

Subdivision Name

COMMUNITY HEALTH CENTER -Call Center

Type

HRSA-Funded Health Center

340B ID

CH04166X

Entity Address

301 SW Crown Point Road
100
WINTER GARDEN, FL 34787-2995

Grant Number

H80CS00809

Participating Start Date

4/1/2017

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

HOLIDAY CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 04465
550 W BURLEIGH BLVD
TAVARES, FL 32778

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