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HOLIDAY CVS, L.L.C.
STD328192 Crew Community Health, Inc
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Covered Entity Details
Entity Name
Crew Community Health, Inc
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD328192
Entity Address
8601 Commodity Circle
103
Orlando, FL 32819
Grant Number
NH25PS004342
Participating Start Date
9/12/2023
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
CVS PHARMACY # 16178
886 W STATE ROAD 436
ALTAMONTE SPRINGS, FL 32714
Pharmacy Comments
Contract Details
Approval Date
9/6/2023
Contract Begin Date
9/14/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Chad Thomas Stowers, President
(407) 605-2253
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/1/2023
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