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HOLIDAY CVS, L.L.C.
RWI33308 AIDS Healthcare Foundation
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Covered Entity Details
Entity Name
AIDS Healthcare Foundation
Subdivision Name
AHF Healthcare Center - North Point
Type
Ryan White Part A
340B ID
RWI33308
Entity Address
6333 N. Federal Highway
Suite 302
Fort Lauderdale, FL 33308
Grant Number
H89HA00002
Participating Start Date
1/1/2013
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05174
1150 NE 26TH ST
WILTON MANORS, FL 33305
Pharmacy Comments
Contract Details
Approval Date
1/14/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rena DeStefano, Director of Pharmacy Finance
(631) 370-2022
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/14/2022
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