Contract Pharmacy Details

HOLIDAY CVS, L.L.C.
HV32935A Unconditional Love, Inc.

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

HOLIDAY CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 00605
1235 N 14TH ST
LEESBURG, FL 34748

Pharmacy Comments

Contract Details

Approval Date

10/13/2023

Contract Begin Date

1/1/2024

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/28/2023
Pharmacy closed

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

10/13/2023

340B Drug Pricing Program Database