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PINE HILLS DRUGS
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
PINE HILLS DRUGS
Pharmacy Address
5000 W COLONIAL DR STE 100
ORLANDO, FL 32808-7602
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
Pine Hills Drugs, Inc
Oscar Mbionwu, Pharmacy Manager
(407) 291-1236
Signed By Date
3/4/2025
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