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HOLIDAY CVS, L.L.C.
STD33150 I&B Medical Associates PLLC
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Covered Entity Details
Entity Name
I&B Medical Associates PLLC
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33150
Entity Address
9400 NW 12 Ave.
Ste. 1
Miami, FL 33150
Grant Number
NH25PS005131
Participating Start Date
7/1/2018
Last Recertification Date
5/8/2024
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 02895
19800 NW 2ND AVE.
MIAMI GARDENS, FL 33169
Pharmacy Comments
Contract Details
Approval Date
4/11/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/8/2025
Ownership change
Contacts
Covered Entity Signing Official
Lisa Barr, Executive Director
(407) 645-2577 Ext: 121
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/11/2023
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