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HOLIDAY CVS, L.L.C.
STD328183 Helping Oppressed & Marginalized Communities to Elevate, Inc.
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Covered Entity Details
Entity Name
Helping Oppressed & Marginalized Communities to Elevate, Inc.
Subdivision Name
HOME-N
Type
Sexually Transmitted Diseases
340B ID
STD328183
Entity Address
855 Outer Road
Orlando, FL 32814
Grant Number
H25PS005131
Participating Start Date
1/1/2022
Last Recertification Date
5/8/2024
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05924
8765 S. DIXIE HWY
PINECREST, FL 33156
Pharmacy Comments
Contract Details
Approval Date
4/9/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Preston J Queenan, President
(484) 868-4948
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/9/2022
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