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HOLIDAY CVS, L.L.C.
RWII34695 AIDS HEALTHCARE FOUNDATION
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Covered Entity Details
Entity Name
AIDS HEALTHCARE FOUNDATION
Subdivision Name
AHF HEALTH POSITIVE/TAMPA BAY
Type
Ryan White Part B
340B ID
RWII34695
Entity Address
3135 STATE ROAD 580
SUITE 1
SAFETY HARBOR, FL 34695
Grant Number
X07HA00057
Participating Start Date
1/1/2011
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05783
8603 WEST HILLSBOROUGH AVE
TAMPA, FL 33615
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
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
7/13/2022
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