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HOLIDAY CVS, L.L.C.
STD328089 Doctors United Group Inc
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Covered Entity Details
Entity Name
Doctors United Group Inc
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD328089
Entity Address
3300 W Colonial Drive
Orlando, FL 32808
Grant Number
NH25PS004342
Participating Start Date
1/1/2020
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03756
2391 W. 68TH ST.
HIALEAH, FL 33016
Pharmacy Comments
Contract Details
Approval Date
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Augustine Carbon, President
(305) 788-0007
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/15/2024
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