Contract Pharmacy Details

TITUSVILLE DISCOUNT PHARMACY
HV32935 UNCONDITIONAL LOVE, INC

Covered Entity Details

Entity Name

UNCONDITIONAL LOVE, INC

Subdivision Name

Type

Ryan White Part C

340B ID

HV32935

Entity Address

1495 N. HARBOR CITY BLVD
MELBOURNE, FL 32935

Grant Number

H76HA00615

Participating Start Date

4/1/2003

Last Recertification Date

3/4/2025

Pharmacy Details

Pharmacy Name

TITUSVILLE DISCOUNT PHARMACY

Pharmacy Address

2175 CHENEY HWY
TITUSVILLE, FL 32780-6792

Pharmacy Comments

Contract Details

Approval Date

7/10/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/21/2023
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Jessica J Seidita, CEO
(321) 259-8928 Ext: 206

Contract Pharmacy Representative

Titusville Discount Pharmacy
Arvindbhai Patel, Manager
(321) 268-0911

Signed By Date

7/10/2020

340B Drug Pricing Program Database