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HOLIDAY CVS, L.L.C.
CH040320 COMMUNITY HEALTH OF SOUTH FL, INC
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Covered Entity Details
Entity Name
COMMUNITY HEALTH OF SOUTH FL, INC
Subdivision Name
DORIS ISON COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH040320
Entity Address
10300 S.W. 216TH ST.
MIAMI, FL 33190
Grant Number
H80CS00821
Participating Start Date
12/1/1992
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05136
11398 QUAIL ROOST DR
MIAMI, FL 33157
Pharmacy Comments
Contract Details
Approval Date
1/10/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Anthony Hall, President & CEO
(305) 252-4853
Contract Pharmacy Representative
Community Health of South Florida
Samuel K James, Pharmacy Director
(305) 254-7166 Ext: 4831
Signed By Date
1/10/2025
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