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HOLIDAY CVS, L.L.C.
STD331931 MIRACLES OF THE HEART INC
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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
CVS PHARMACY # 16225
15005 SW 88TH ST
MIAMI, FL 33196
Pharmacy Comments
Contract Details
Approval Date
10/9/2024
Contract Begin Date
1/1/2025
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
10/9/2024
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