Contract Pharmacy Details

WALGREEN CO.
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

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 05494
1333 N HARBOR CITY BLVD
MELBOURNE, FL 32935

Pharmacy Comments

Contract Details

Approval Date

10/14/2024

Contract Begin Date

1/1/2025

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

2/27/2025
Pharmacy closed

Contacts

Covered Entity Signing Official

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

Contract Pharmacy Representative

Walgreens
Karl Mechan, Vice President Health Systems Programs
(847) 315-2663

Signed By Date

10/14/2024

340B Drug Pricing Program Database