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HOLIDAY CVS, L.L.C.
RWI33033 AIDS Healthcare Foundation
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Covered Entity Details
Entity Name
AIDS Healthcare Foundation
Subdivision Name
AHF Healthcare Center- Homestead
Type
Ryan White Part A
340B ID
RWI33033
Entity Address
2826 NE 8th Street
Suite B-13
Homestead, FL 33033
Grant Number
H89HA00005
Participating Start Date
7/1/2015
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05174
1150 NE 26TH ST
WILTON MANORS, FL 33305
Pharmacy Comments
Contract Details
Approval Date
4/12/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rena DeStefano, Director of Pharmacy Finance
(631) 370-2022
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/12/2024
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