Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
STD336053 Metropolitan Charities, Inc.

Covered Entity Details

Entity Name

Metropolitan Charities, Inc.

Subdivision Name

Type

Sexually Transmitted Diseases

340B ID

STD336053

Entity Address

2105 N Nebraska Ave
Tampa, FL 33602-2558

Grant Number

NU62PS924698

Participating Start Date

5/15/2023

Last Recertification Date

Entity Termination Date

1/1/2024

Pharmacy Details

Pharmacy Name

HOLIDAY CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 03260
7325 STATE ROAD 54
NEW PORT RICHEY, FL 34653

Pharmacy Comments

Contract Details

Approval Date

5/15/2023

Contract Begin Date

6/12/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2024
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Priya Rajkumar, Chief Executive Officer
(727) 321-3854 Ext: 1230

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

4/14/2023

340B Drug Pricing Program Database