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HOLIDAY CVS, L.L.C.
STD336261 Harmony Healthcare Orlando, Inc
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Covered Entity Details
Entity Name
Harmony Healthcare Orlando, Inc
Subdivision Name
Harmony Healthcare, Inc
Type
Sexually Transmitted Diseases
340B ID
STD336261
Entity Address
13047 W. Linebaugh Ave
Suite 101
Tampa, FL 33626
Grant Number
NH25PS005131
Participating Start Date
7/1/2021
Last Recertification Date
5/31/2024
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05196
11670 COUNTRYWAY BLVD
TAMPA, FL 33626
Pharmacy Comments
Contract Details
Approval Date
1/18/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/25/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Priscilla Torres, Executive Director
(407) 777-2022
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/18/2022
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