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PUERTO RICO CVS PHARMACY, L.L.C.
STD33815 Pineapple Healthcare Inc.
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Covered Entity Details
Entity Name
Pineapple Healthcare Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33815
Entity Address
1253 W Memorial Blvd
Lakeland, FL 33815
Grant Number
NH25PS005131
Participating Start Date
10/1/2024
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
PUERTO RICO CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 04594
2114 CARR. 2
BAYAMON, PR 00961
Pharmacy Comments
Contract Details
Approval Date
8/7/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ethan Michael Suarez, President
(407) 839-7278
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/11/2024
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