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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
DBA: CVS/PHARMACY # 03114
2400 ENTERPRISE RD.
ORANGE CITY, FL 32763
Pharmacy Comments
Contract Details
Approval Date
6/29/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Colin C Conner II, CEO
(407) 924-7620
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
6/29/2021
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