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HOLIDAY CVS, L.L.C.
STD333051 Midway Specialty Care Center
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Covered Entity Details
Entity Name
Midway Specialty Care Center
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD333051
Entity Address
2608 NE 16th Avenue
WILTON MANORS, FL 33334
Grant Number
NH25PS005131
Participating Start Date
4/1/2018
Last Recertification Date
5/12/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
CVS PHARMACY # 17323
10720 SW VILLAGE PKWY
PORT ST LUCIE, FL 34987
Pharmacy Comments
Contract Details
Approval Date
4/11/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kathryn E Hayden, CFO
(772) 742-9276
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/11/2025
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