Contract Pharmacy Details

SOUTH CAROLINA CVS PHARMACY, L.L.C.
RWI32825 Hope and Help Center of Central Florida Inc.

Covered Entity Details

Entity Name

Hope and Help Center of Central Florida Inc.

Subdivision Name

Hope and Help Center of Central Florida, Inc.

Type

Ryan White Part A

340B ID

RWI32825

Entity Address

4122 Metric Dr.
Suite 800
Winter Park, FL 32792-6809

Grant Number

H89HA00030

Participating Start Date

7/1/2018

Last Recertification Date

1/29/2020

Entity Termination Date

4/1/2021

Pharmacy Details

Pharmacy Name

SOUTH CAROLINA CVS PHARMACY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 05515
601 HWY 17 NORTH
SURFSIDE BEACH, SC 29575

Pharmacy Comments

Contract Details

Approval Date

7/16/2018

Contract Begin Date

10/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2021
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Lisa Barr, Executive Director
(407) 645-2577 Ext: 121

Contract Pharmacy Representative

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

Signed By Date

7/16/2018

340B Drug Pricing Program Database