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HOLIDAY CVS, L.L.C.
STD323011 big bend cares
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Covered Entity Details
Entity Name
big bend cares
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD323011
Entity Address
2200 S Monroe St
Tallahassee, FL 32301
Grant Number
6 NH25PS005131-05-04
Participating Start Date
1/1/2017
Last Recertification Date
5/13/2024
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 00633
3090 S MONROE ST
TALLAHASSEE, FL 32301
Pharmacy Comments
Contract Details
Approval Date
4/4/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/1/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Robert Renzi, CEO
(850) 656-2437 Ext: 240
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/4/2018
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