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HOLIDAY CVS, L.L.C.
STD328062 Bliss Cares
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Covered Entity Details
Entity Name
Bliss Cares
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD328062
Entity Address
3901 E Colonial Drive
ORLANDO, FL 32803
Grant Number
NH25PS005131
Participating Start Date
7/1/2016
Last Recertification Date
5/7/2024
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 00204
5899 ORANGE BLOSSOM TRL
ORLANDO, FL 32839
Pharmacy Comments
Contract Details
Approval Date
4/15/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Juan Rodriguez, Executive Director
(407) 761-3361
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/15/2019
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