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HOLIDAY CVS, L.L.C.
STD33024 Alpha Omega Alliance Inc
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Covered Entity Details
Entity Name
Alpha Omega Alliance Inc
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33024
Entity Address
2800 E Commercial Blvd
Suite 210
Ft Lauderdale, FL 33308
Grant Number
NH25PS005131
Participating Start Date
12/4/2019
Last Recertification Date
5/15/2024
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
CVS PHARMACY # 17484
1760 PALM BEACH LAKES BLVD
WEST PALM BEACH, FL 33401
Pharmacy Comments
Contract Details
Approval Date
1/15/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Monique D Brown Wellons, CEO
(561) 510-0471
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/15/2020
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