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HOLIDAY CVS, L.L.C.
STD33777 Empath Health, Inc
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Covered Entity Details
Entity Name
Empath Health, Inc
Subdivision Name
AIDS Service Association of Pinellas dba EPIC
Type
Sexually Transmitted Diseases
340B ID
STD33777
Entity Address
8787 Bryan Dairy Rd
230
Largo, FL 33777
Grant Number
1NU62PS924687-1-00
Participating Start Date
8/16/2023
Last Recertification Date
5/9/2024
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
CVS PHARMACY # 16182
10500 ULMERTON RD
LARGO, FL 33771
Pharmacy Comments
Contract Details
Approval Date
8/16/2023
Contract Begin Date
8/16/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Saida Bouhamid, Chief Mission Financial Officer
(727) 523-3339
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
5/16/2023
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