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HOLIDAY CVS, L.L.C.
HM8395 The Ohio State University Hemostasis and Thrombosis Center at the James
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Covered Entity Details
Entity Name
The Ohio State University Hemostasis and Thrombosis Center at the James
Subdivision Name
HEMOPHILIA TREATMENT CENTER
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM8395
Entity Address
460 W. 10th Avenue
COLUMBUS, OH 43210
Grant Number
H30MC24047
Participating Start Date
1/1/2003
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
CVS PHARMACY # 17383
1890 NE PINE ISLAND ROAD
CAPE CORAL, FL 33909
Pharmacy Comments
Contract Details
Approval Date
1/4/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nicolas Gallastegui Crestani, Director of Hemostasis and Thrombosis Center
(614) 293-9441
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/4/2024
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