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HOLIDAY CVS, L.L.C.
RWI32825 Hope and Help Center of Central Florida Inc.
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Covered Entity Details
Entity Name
Hope and Help Center of Central Florida Inc.
Subdivision Name
Hope and Help Center of Central Florida, Inc.
Type
Ryan White Part A
340B ID
RWI32825
Entity Address
4122 Metric Dr.
Suite 800
Winter Park, FL 32792-6809
Grant Number
H89HA00030
Participating Start Date
7/1/2018
Last Recertification Date
1/29/2020
Entity Termination Date
4/1/2021
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 00190
3212 CURRY FORD RD
ORLANDO, FL 32806
Pharmacy Comments
Contract Details
Approval Date
4/3/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Lisa Barr, Executive Director
(407) 645-2577 Ext: 121
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/3/2018
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