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HOLIDAY CVS, L.L.C.
STD34982 Midway Specialty Care Center
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Covered Entity Details
Entity Name
Midway Specialty Care Center
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD34982
Entity Address
356 E MIDWAY ROAD
FORT PIERCE, FL 34982
Grant Number
NH25PS005131
Participating Start Date
1/1/2018
Last Recertification Date
5/8/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03779
530 TRUMAN AVE
KEY WEST, FL 33040
Pharmacy Comments
Contract Details
Approval Date
7/15/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kathryn E Hayden, CFO
(772) 742-9276
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/15/2020
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