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HOLIDAY CVS, L.L.C.
STD33013 Barroso Medical Services,LLC
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Covered Entity Details
Entity Name
Barroso Medical Services,LLC
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33013
Entity Address
4835 E 4th Ave
Suite B
Hialeah, FL 33013
Grant Number
NH25PS005131
Participating Start Date
7/1/2020
Last Recertification Date
5/7/2024
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA NAVARRO DISCOUNT PHARMACY #11087
802 E. 25TH STREET
HIALEAH, FL 33013
Pharmacy Comments
Contract Details
Approval Date
7/7/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ihosvani Barroso, MD,CEO
(786) 899-0119
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/7/2021
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