Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
HV32935B Unconditional Love, Inc.

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

HOLIDAY CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 05864
1820 CHENEY HIGHWAY
TITUSVILLE, FL 32780

Pharmacy Comments

Contract Details

Approval Date

4/14/2022

Contract Begin Date

7/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

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

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

4/14/2022

340B Drug Pricing Program Database