Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
RWI33133 AIDS HEALTHCARE FOUNDATION

Covered Entity Details

Entity Name

AIDS HEALTHCARE FOUNDATION

Subdivision Name

AHF KINDER MEDICAL GROUP

Type

Ryan White Part A

340B ID

RWI33133

Entity Address

3661 S. MIAMI AVENUE, SUITE 806
MIAMI BEACH, FL 33133

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 # 03672
13749 SW 152ND ST
MIAMI, FL 33177

Pharmacy Comments

Contract Details

Approval Date

1/17/2023

Contract Begin Date

4/1/2023

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

1/17/2023

340B Drug Pricing Program Database