340B Drug Pricing Program Database


AVITA HEALTH SYSTEM - information as of 5/16/2025 12:48:40 AM


AVITA HEALTH SYSTEM

D.B.A AVITA CRESTLINE PHARMACY
385 N SELTZER ST UNIT 4
CRESTLINE, OH 44827



  • Contracts
  • History
Contracts
Contract Detail340B IDEntity NameSub NameEntity TypeAddressAddress Cont.CityStateBegin DateTerm DateEdit Date
DetailsCAH361316-00BUCYRUS COMMUNITY HOSPITAL Critical Access Hospital629 N SANDUSKY AVENUE
BUCYRUSOH07/01/2025 4/15/2025 4:08 PM
DetailsCAH361316-02BUCYRUS COMMUNITY HOSPITALProvider Based Clinic - Hill Street Suite B (PBC 140B)Critical Access Hospital140 Hill Street
B
BucyrusOH07/01/2025 4/15/2025 4:08 PM
DetailsCAH361316-03BUCYRUS COMMUNITY HOSPITALProvider Based Clinic - (PBC 629)Critical Access Hospital629 North Sandusky Avenue
BucyrusOH07/01/2025 4/15/2025 4:08 PM
DetailsCAH361316-04BUCYRUS COMMUNITY HOSPITALProvider Based Clinic - Hill Street (PBC 124) - Physician PracticeCritical Access Hospital124 Hill Street
BucyrusOH07/01/2025 4/15/2025 4:08 PM
DetailsCAH361316-05BUCYRUS COMMUNITY HOSPITALProvider Based Clinic - Hill Street Suite A (PBC 140A) - PediatricsCritical Access Hospital140 Hill Street
A
BucyrusOH07/01/2025 4/15/2025 4:09 PM
DetailsCAH361316-06BUCYRUS COMMUNITY HOSPITALProvider Based Clinic - Hill Street Suite C (PBC 140C) - Physician OfficeCritical Access Hospital140 Hill Street Suite C
BucyrusOH07/01/2025 4/15/2025 4:08 PM
DetailsCAH361316-07BUCYRUS COMMUNITY HOSPITALProvider Based Clinic - Hill Street (PBC 130) - Pain ClinicCritical Access Hospital130 Hill Street
BucyrusOH07/01/2025 4/22/2025 9:06 AM
DetailsDSH360365AVITA ONTARIO HOSPITAL Disproportionate Share Hospital715 RICHLAND MALL
ONTARIOOH07/01/2025 4/15/2025 4:13 PM
DetailsDSH360365AAVITA ONTARIO HOSPITALProvider Based Clinic - Richland Mall (PBC 600 - 203) - Internal MedDisproportionate Share Hospital600 Richland Mall, Ste 203
OntarioOH07/01/2025 4/15/2025 4:13 PM
DetailsDSH360365BAVITA ONTARIO HOSPITALProvider Based Clinic - Richland Mall (PBC 600 - 203) - Family MedicineDisproportionate Share Hospital600 Richland Mall, STE 203
OntarioOH07/01/2025 4/15/2025 4:13 PM
DetailsDSH360365CAVITA ONTARIO HOSPITALProvider Based Clinic - Richland Mall (PBC 600 - 204) - Pediatric Provider OfficeDisproportionate Share Hospital600 Richland Mall, Ste 204
OntarioOH07/01/2025 4/15/2025 4:14 PM
DetailsDSH360365DAVITA ONTARIO HOSPITALProvider Based Clinic - Richland Mall (PBC 600 - 205) - Neurology Provider OfficeDisproportionate Share Hospital600 Richland Mall, Ste 205
OntarioOH07/01/2025 4/15/2025 4:14 PM
DetailsDSH360365EAVITA ONTARIO HOSPITALProvider Based Clinic - Richland Mall (PBC 600 - 205) - EndocrinologyDisproportionate Share Hospital600 Richland Mall
205
OntarioOH07/01/2025 4/15/2025 4:13 PM
DetailsDSH360365FAVITA ONTARIO HOSPITALProvider Based Clinic - Richland Mall (PBC 600 - 205) - Plastic SurgeryDisproportionate Share Hospital600 Richland Mall
205
OntarioOH07/01/2025 4/15/2025 4:14 PM
DetailsDSH360365GAVITA ONTARIO HOSPITALProvider Based Clinic - Richland Mall (PBC 600 - 201) - Pain ClinicDisproportionate Share Hospital600 Richland Mall
201
OntarioOH07/01/2025 4/15/2025 4:15 PM
DetailsDSH360365HAVITA ONTARIO HOSPITALProvider Based Clinic - Richland Mall (PBC 600 - 202) - Medication ManagementDisproportionate Share Hospital600 Richland Mall
202
OntarioOH07/01/2025 4/15/2025 4:14 PM
DetailsDSH360365JAVITA ONTARIO HOSPITALProvider Based Clinic - Richland Mall (PBC 600 - 205) - PulmonaryDisproportionate Share Hospital600 Richland Mall, Ste 205
OntarioOH07/01/2025 5/5/2025 7:41 AM
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsCommentsInsert   11/13/2024 12:06 PM
DetailsIs DeletedInsert  False11/13/2024 12:06 PM
AddressesPharmacy AddressInsert  AVITA HEALTH SYSTEM D.B.A AVITA CRESTLINE PHARMACY 385 N SELTZER ST UNIT 4 CRESTLINE, OH 4482711/13/2024 12:06 PM
DetailsNameInsert  AVITA HEALTH SYSTEM11/13/2024 12:06 PM