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Walgreens #21395
HV32935A Unconditional Love, Inc.
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Covered Entity Details
Entity Name
Unconditional Love, Inc.
Subdivision Name
Type
Ryan White Part C
340B ID
HV32935A
Entity Address
1509 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 #21395
Pharmacy Address
Walgreens Central Fill #21395
5710 Young Pine Rd
Orlando, FL 32829
Pharmacy Comments
Contract Details
Approval Date
7/17/2023
Contract Begin Date
10/1/2023
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
7/17/2023
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