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HOLIDAY CVS, L.L.C.
STD3280612 Sunshine Specialty Health Outreach Foundation
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Covered Entity Details
Entity Name
Sunshine Specialty Health Outreach Foundation
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD3280612
Entity Address
220 E. Gore St
Orlando, FL 32806
Grant Number
5nu62ps924532-02
Participating Start Date
10/12/2022
Last Recertification Date
5/7/2024
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 00204
5899 ORANGE BLOSSOM TRL
ORLANDO, FL 32839
Pharmacy Comments
Contract Details
Approval Date
1/10/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jillian Hall, President
(407) 325-1299
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/10/2023
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