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HOLIDAY CVS, L.L.C.
STD336173 Midway Specialty Care Center Inc
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Covered Entity Details
Entity Name
Midway Specialty Care Center Inc
Subdivision Name
Sexually Transmitted Diseases
Type
Sexually Transmitted Diseases
340B ID
STD336173
Entity Address
11454 N 53rd Street
Temple Terrace, FL 33617
Grant Number
NH25PS005131
Participating Start Date
4/1/2022
Last Recertification Date
5/12/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 02893
4040 PRAIRIE AVE.
MIAMI BEACH, FL 33140
Pharmacy Comments
Contract Details
Approval Date
2/15/2022
Contract Begin Date
4/1/2022
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
1/18/2022
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