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WALGREENS SPECIALTY PHARMACY, LLC
HV32935B Unconditional Love, Inc.
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Covered Entity Details
Entity Name
Unconditional Love, Inc.
Subdivision Name
Type
Ryan White Part C
340B ID
HV32935B
Entity Address
1513 N. Harbor City Blvd.
Administration
Melbourne, FL 32935
Grant Number
H76HA00615
Participating Start Date
4/1/2021
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
WALGREENS SPECIALTY PHARMACY, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15438
41460 HAGGERTY CIR S
CANTON, MI 48188
Pharmacy Comments
Contract Details
Approval Date
1/15/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jessica J Seidita, CEO
(321) 259-8928 Ext: 206
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/15/2021
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