Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
STD347419 Positive Assistance, Inc.

Covered Entity Details

Entity Name

Positive Assistance, Inc.

Subdivision Name

NU HEALTHCARE INC.

Type

Sexually Transmitted Diseases

340B ID

STD347419

Entity Address

1016 Mann St
Kissimmee, FL 34741

Grant Number

5NU62PS924532-02

Participating Start Date

7/1/2023

Last Recertification Date

5/20/2024

Entity Termination Date

7/1/2025

Pharmacy Details

Pharmacy Name

HOLIDAY CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY #1813
2449 E SILVER SPRINGS BLVD
OCALA, FL 34470

Pharmacy Comments

Contract Details

Approval Date

4/11/2024

Contract Begin Date

7/1/2024

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2025
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Andre J Antenor, President
(863) 242-3322

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

4/11/2024

340B Drug Pricing Program Database