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KAILASH PHARMACY 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
KAILASH PHARMACY LLC
Pharmacy Address
COMMUNITY PHARMACY OF HOLLY HILL
1107 N NOVA RD
DAYTONA BEACH, FL 32117
Pharmacy Comments
Contract Details
Approval Date
3/4/2025
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
KAILASH PHARMACY LLC
KALPESH PATEL, PHARMACY OWNER
(321) 946-6332
Signed By Date
3/4/2025
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