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RX AVE HEALTH 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
RX AVE HEALTH LLC
Pharmacy Address
RX AVE HEALTH
401 N WICKHAM RD STE W
MELBOURNE, FL 32935
Pharmacy Comments
Contract Details
Approval Date
5/3/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/31/2024
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
RX One
Sam Sharma, Regional Manager
(321) 952-0656
Signed By Date
5/3/2023
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