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HOLIDAY CVS, L.L.C.
CH040310 BORINQUEN HEALTH CARE CENTER INC
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Covered Entity Details
Entity Name
BORINQUEN HEALTH CARE CENTER INC
Subdivision Name
BMC Emilio Lopez Pavilion (Main Site)
Type
HRSA-Funded Health Center
340B ID
CH040310
Entity Address
3601 Federal Hwy
Miami, FL 33137-3795
Grant Number
H80CS00618
Participating Start Date
4/1/1996
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 04249
11890 BISCAYNE BLVD
MIAMI, FL 33181
Pharmacy Comments
Contract Details
Approval Date
4/4/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paul Carl Velez, CEO
(305) 788-5055
Contract Pharmacy Representative
Caremark L.L.C.
Christian reid, 340b Program Director
(401) 770-2118
Signed By Date
4/4/2024
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