Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
CHC28344-01 BANYAN COMMUNITY HEALTH CENTER, INC.

Covered Entity Details

Entity Name

BANYAN COMMUNITY HEALTH CENTER, INC.

Subdivision Name

Banyan Community Health Center 3850 Miami

Type

HRSA-Funded Health Center

340B ID

CHC28344-01

Entity Address

3850 W FLAGLER ST
MIAMI, FL 33134-1604

Grant Number

H80CS28344

Participating Start Date

1/1/2016

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

HOLIDAY CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 04032
855 E 8TH AVE
HIALEAH, FL 33010

Pharmacy Comments

Contract Details

Approval Date

1/7/2022

Contract Begin Date

4/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Ileana Ruiz Garcia, Executive DIrector
(305) 398-6132

Contract Pharmacy Representative

CVS
Meagan Stevens, Sales Executive
(407) 457-2409

Signed By Date

1/7/2022

340B Drug Pricing Program Database