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HOLIDAY CVS, L.L.C.
STD331391 PREVENTION 305
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Covered Entity Details
Entity Name
PREVENTION 305
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD331391
Entity Address
407 Lincoln Road, Suite 6D
MIAMI BEACH, FL 33139
Grant Number
NH25PS005131
Participating Start Date
5/8/2020
Last Recertification Date
5/9/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 00574
8001 9TH ST N
SAINT PETERSBURG, FL 33702
Pharmacy Comments
Contract Details
Approval Date
1/8/2025
Contract Begin Date
1/10/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Patrick Whiteside, Chief Executive Officer
(866) 773-7305 Ext: 100
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/8/2025
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