Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
STD331931 MIRACLES OF THE HEART INC

Covered Entity Details

Entity Name

MIRACLES OF THE HEART INC

Subdivision Name

Type

Sexually Transmitted Diseases

340B ID

STD331931

Entity Address

15668 SW 72 Street
Miami, FL 33193

Grant Number

NH25PS004342

Participating Start Date

1/1/2024

Last Recertification Date

5/6/2024

Pharmacy Details

Pharmacy Name

HOLIDAY CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 03443
5695 SW 8TH ST
MIAMI, FL 33144

Pharmacy Comments

Contract Details

Approval Date

7/14/2024

Contract Begin Date

10/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

DELIA KENNEDY, COO
(786) 556-1397

Contract Pharmacy Representative

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

Signed By Date

7/14/2024

340B Drug Pricing Program Database