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HOLIDAY CVS, L.L.C.
STD33713 Metropolitan Charities, Inc.
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Covered Entity Details
Entity Name
Metropolitan Charities, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33713
Entity Address
701 94th Avenue North
Suite 250
Saint Petersburg, FL 33702
Grant Number
NU62PS924698
Participating Start Date
5/15/2023
Last Recertification Date
5/7/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
CVS PHARMACY # 17132
1544 N DALE MABRY HWY
TAMPA, FL 33607
Pharmacy Comments
Contract Details
Approval Date
10/11/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Priya Rajkumar, Chief Executive Officer
(727) 321-3854 Ext: 1230
Contract Pharmacy Representative
CVS
Walter Jury, Account Manager
(315) 271-5312
Signed By Date
10/11/2023
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