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HOLIDAY CVS, L.L.C.
STD328059 Positive Assistance, Inc.
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Covered Entity Details
Entity Name
Positive Assistance, Inc.
Subdivision Name
Positive Assistance Health Center
Type
Sexually Transmitted Diseases
340B ID
STD328059
Entity Address
750 S. Orange Blossom Trail
Suite 222
Orlando, FL 32805
Grant Number
5NU62PS924532-02
Participating Start Date
7/1/2019
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
2/24/2023
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
2/24/2023
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