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Walgreens #21395
STD329352 Unconditional Love, Inc.
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Covered Entity Details
Entity Name
Unconditional Love, Inc.
Subdivision Name
1509 STD
Type
Sexually Transmitted Diseases
340B ID
STD329352
Entity Address
1509 N. Harbor City Blvd.
Melbourne, FL 32935
Grant Number
5NU62PS924532
Participating Start Date
10/1/2023
Last Recertification Date
5/15/2024
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
10/14/2024
Contract Begin Date
1/1/2025
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
10/14/2024
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