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HOLIDAY CVS, L.L.C.
RWI33316C CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
North Miami
Type
Ryan White Part A
340B ID
RWI33316C
Entity Address
18360 NW 47th Ave
Miami Gardens, FL 33055
Grant Number
H89HA00005
Participating Start Date
7/1/2020
Last Recertification Date
3/10/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 00628
600 NE 128TH ST
NORTH MIAMI, FL 33161
Pharmacy Comments
Contract Details
Approval Date
7/26/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rishi Patel, President & CEO
(941) 300-4440 Ext: 11127
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/26/2024
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