Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
RWI33169 AIDS HEALTHCARE FOUNDATION

Covered Entity Details

Entity Name

AIDS HEALTHCARE FOUNDATION

Subdivision Name

AHF HEALTHCARE CENTER - JACKSON NORTH

Type

Ryan White Part A

340B ID

RWI33169

Entity Address

100 N.W. 170th Street, Suite 208
North Miami Beach, FL 33169-4518

Grant Number

H89HA00005

Participating Start Date

10/1/2013

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

HOLIDAY CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 05824
2515 SHADOWLAWN DR.
NAPLES, FL 34112

Pharmacy Comments

Contract Details

Approval Date

10/10/2022

Contract Begin Date

1/1/2023

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

10/10/2022

340B Drug Pricing Program Database