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KAILASHRX LLC
STD327205 LIVE LOVE LIFE, INC.
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Covered Entity Details
Entity Name
LIVE LOVE LIFE, INC.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD327205
Entity Address
228 S. WOODLAND BLVD
DELAND, FL 32720
Grant Number
NH25PS005131
Participating Start Date
4/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
KAILASHRX LLC
Pharmacy Address
DBA: COMMUNITY PHARMACY OF DELTONA
1240 PROVIDENCE BLVD UNIT 1&2
DELTONA, FL 32725
Pharmacy Comments
Contract Details
Approval Date
2/18/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MARK A WALCZYK, CHIEF EXECUTIVE OFFICER
(585) 233-0105
Contract Pharmacy Representative
Deltona Pharmacy
jayesh mehta, Pharmacy
(407) 729-2870
Signed By Date
1/15/2025
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