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| Contract Detail | BIOPLUS SPECIALTY PHARMACY LA, LLC | 2731 MANHATTAN BLVD STE B17 |
| HARVEY | LA | 70058 | 03/04/2025 | 04/01/2025 | | | 04/01/2025 |
| Contract Detail | BIOPLUS SPECIALTY PHARMACY, INC | 3200 LAKE EMMA RD UNIT 1000 |
| LAKE MARY | FL | 32746 | 03/04/2025 | 04/01/2025 | | | 04/01/2025 |
| Contract Detail | KAILASH PHARMACY LLC | COMMUNITY PHARMACY OF HOLLY HILL |
1107 N NOVA RD
| DAYTONA BEACH | FL | 32117 | 03/04/2025 | 04/01/2025 | | | 04/01/2025 |
| Contract Detail | KAILASHRX LLC | DBA: COMMUNITY PHARMACY OF DELTONA |
1240 PROVIDENCE BLVD UNIT 1&2
| DELTONA | FL | 32725 | 02/18/2025 | 04/01/2025 | | | 04/01/2025 |
| Contract Detail | PINE HILLS DRUGS | 5000 W COLONIAL DR STE 100 |
| ORLANDO | FL | 32808-7602 | 03/04/2025 | 04/01/2025 | | | 04/01/2025 |
| Contract Detail | RXHEALTHCARE SYSTEM LLC | DBA:COMMUNITY PHARMACY OF PORT ORANGE |
3755 S NOVA RD STE A
| PORT ORANGE | FL | 32129 | 03/04/2025 | 04/01/2025 | | | 04/01/2025 |
| Contract Detail | XINIM-CORP | HOLLY HILL PHARMACY |
1702 RIDGEWOOD AVE STE C-G
| HOLLY HILL | FL | 32117 | 03/04/2025 | 04/01/2025 | | | 04/01/2025 |
| Contacts | Primary Contact | Update | Change Request | Nabe, Holly
Executive Assistant
Live Love Life, Inc.
3862135728 | KURASH-HAYMES, BRADFORD
CHIEF OPERATING OFFICER
LIVE LOVE LIFE, INC.
3865894963 | 4/7/2025 7:24 AM |
| Contacts | Authorizing Official | Update | Profile Change Request | WALCZYK, MARK A
CHIEF OPERATING OFFICER
LIVE LOVE LIFE INC
5852330105 | WALCZYK, MARK A
CHIEF EXECUTIVE OFFICER
LIVE LOVE LIFE INC
5852330105 | 4/4/2025 5:59 AM |
| Contacts | Signed By | Update | Profile Change Request | WALCZYK, MARK A
CHIEF OPERATING OFFICER
LIVE LOVE LIFE INC
5852330105 | WALCZYK, MARK A
CHIEF EXECUTIVE OFFICER
LIVE LOVE LIFE INC
5852330105 | 4/4/2025 5:59 AM |
| Details | State | Update | | Approved | Active | 4/1/2025 12:01 AM |
| Contacts | Signed By | Insert | New Registration | | WALCZYK, MARK A
CHIEF OPERATING OFFICER
LIVE LOVE LIFE INC
5852330105 | 2/18/2025 9:25 AM |
| Details | 340B ID | Update | New Registration | | STD327205 | 2/18/2025 9:25 AM |
| Dates | Participating Approval Date | Update | New Registration | | 2/18/2025 9:25:52 AM | 2/18/2025 9:25 AM |
| Details | State | Update | New Registration | Pending | Approved | 2/18/2025 9:25 AM |
| Dates | Signed By Date | Update | New Registration | | 1/15/2025 6:48:18 PM | 2/18/2025 9:25 AM |
| Dates | Start Date | Update | New Registration | | 4/1/2025 12:00:00 AM | 2/18/2025 9:25 AM |
| Addresses | Main Address | Insert | New Registration | |
228 S. WOODLAND BLVD
DELAND, FL 32720 | 1/15/2025 6:48 PM |
| Addresses | Billing Address | Insert | New Registration | | LIVE LOVE LIFE, DELAND
1700 RIDGEWOOD AVE
SUITE i
HOLLY HILL, FL 32117 | 1/15/2025 6:48 PM |
| Details | Nature of Support: In Kind Support Description | Insert | New Registration | | HIV test kits, testing supplies, condoms, educational materials, in person and online training | 1/15/2025 6:48 PM |
| Details | Nature Of Support | Insert | New Registration | | In-Kind products or services (see note below; must have been purchased with section 318 funds) | 1/15/2025 6:48 PM |
| Details | Nature of Support: Support Received From Date | Insert | New Registration | | 10/25/2024 12:00:00 AM | 1/15/2025 6:48 PM |
| Details | Nature of Support: Support Received To Date | Insert | New Registration | | 12/14/2026 12:00:00 AM | 1/15/2025 6:48 PM |
| Contacts | Authorizing Official | Insert | New Registration | | WALCZYK, MARK A
CHIEF OPERATING OFFICER
LIVE LOVE LIFE INC
5852330105 | 1/15/2025 6:48 PM |
| Contacts | Primary Contact | Insert | New Registration | | Nabe, Holly
Executive Assistant
Live Love Life, Inc.
3862135728 | 1/15/2025 6:48 PM |
| Details | Assistance Received From Date | Insert | New Registration | | | 1/15/2025 6:48 PM |
| Details | Assistance Received To Date | Insert | New Registration | | | 1/15/2025 6:48 PM |
| Details | Last Recertification Date | Insert | New Registration | | | 1/15/2025 6:48 PM |
| Details | Grant Number | Insert | New Registration | | NH25PS005131 | 1/15/2025 6:48 PM |
| Details | 340B ID | Insert | New Registration | | | 1/15/2025 6:48 PM |
| Details | Is Authorizing Official EHB Data | Insert | New Registration | | | 1/15/2025 6:48 PM |
| Dates | Last Date That 340B Drugs Purchased | Insert | New Registration | | | 1/15/2025 6:48 PM |
| Details | Medicare Provider Number | Insert | New Registration | | | 1/15/2025 6:48 PM |
| Details | Entity Name | Insert | New Registration | | LIVE LOVE LIFE, INC. | 1/15/2025 6:48 PM |
| Details | NOFO Number | Insert | New Registration | | PS18-1802 | 1/15/2025 6:48 PM |
| Details | Program Code | Insert | New Registration | | STD | 1/15/2025 6:48 PM |
| Details | Entity Subname | Insert | New Registration | | | 1/15/2025 6:48 PM |
| Dates | Participating Approval Date | Insert | New Registration | | | 1/15/2025 6:48 PM |
| Details | State | Insert | New Registration | | Pending | 1/15/2025 6:48 PM |
| Dates | Registration Date | Insert | New Registration | | 1/15/2025 6:48:16 PM | 1/15/2025 6:48 PM |
| Dates | Signed By Date | Insert | New Registration | | | 1/15/2025 6:48 PM |
| Dates | Start Date | Insert | New Registration | | | 1/15/2025 6:48 PM |
| Terminations | Termination Comments | Insert | New Registration | | | 1/15/2025 6:48 PM |
| Terminations | Termination Date | Insert | New Registration | | | 1/15/2025 6:48 PM |
| Terminations | Termination Effective Date | Insert | New Registration | | | 1/15/2025 6:48 PM |
| Terminations | Termination Reason | Insert | New Registration | | | 1/15/2025 6:48 PM |