Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
STD33812 Positive Assistance, Inc.

Covered Entity Details

Entity Name

Positive Assistance, Inc.

Subdivision Name

Florida ID Care

Type

Sexually Transmitted Diseases

340B ID

STD33812

Entity Address

14192 Metropolis Ave
Fort Myers, FL 33812

Grant Number

5NU62PS924532-02

Participating Start Date

1/1/2023

Last Recertification Date

5/15/2024

Pharmacy Details

Pharmacy Name

HOLIDAY CVS, L.L.C.

Pharmacy Address

CVS PHARMACY # 16265
13711 S TAMIAMI TRL
FORT MYERS, FL 33912

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

340B Drug Pricing Program Database