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HOLIDAY CVS, L.L.C.
STD328067 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
STD328067
Entity Address
6000 Turkey Lake Road
Unit 110
Orlando, FL 32819
Grant Number
NH25PS005131
Participating Start Date
1/1/2019
Last Recertification Date
5/14/2024
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 01274
2790 N ROOSEVELT BLVD
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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