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HOLIDAY CVS, L.L.C.
STD347417 Positive Assistance, Inc.
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Covered Entity Details
Entity Name
Positive Assistance, Inc.
Subdivision Name
Orlando Gastroenterology, PA
Type
Sexually Transmitted Diseases
340B ID
STD347417
Entity Address
201 Hilda Street
# 25
Kissimmee, FL 34741
Grant Number
5NU62PS924532-02
Participating Start Date
7/1/2022
Last Recertification Date
5/15/2024
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 04645
2351 S HIAWASSEE RD
ORLANDO, FL 32835
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
Andre J Antenor, President
(863) 242-3322
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/17/2023
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