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HOLIDAY CVS, L.L.C.
STD334611 Best Choice Medi Clinic
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Covered Entity Details
Entity Name
Best Choice Medi Clinic
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD334611
Entity Address
1195 n. Military Trail, Suite 5 B
West Palm Beach, FL 33409
Grant Number
5NU62PS92453202
Participating Start Date
7/1/2021
Last Recertification Date
5/7/2024
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03222
4511 LANTANA RD
LAKE WORTH, FL 33463
Pharmacy Comments
Contract Details
Approval Date
7/13/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Alisha Kuttiyani, CEO
(305) 450-7518
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/13/2022
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