340B Drug Pricing Program Database

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AVITA PHARMACY 1073
RWI787520 Waterloo Counseling Center

Covered Entity Details

Ryan White Part A
RWI787520
314 East Highland Mall Blvd.
Austin, TX 78752
2 H89HA000362400
10/1/2018
1/28/2020
4/1/2021


Pharmacy Details

AVITA DRUGS LLC DBA AVITA PHARMACY 1073
300 SOUTH 2ND STREET
SUIT 102
MCALLEN, TX 78501

Contract Details

8/27/2018
10/1/2018

4/1/2021
Covered Entity Terminated


Contacts


Carol L Drennan, Executive Director
(512) 444-9922 Ext: 5124449922



AVITA Pharmacy
JERRY PURCEL, Executive VP
(504) 905-4587
7/17/2018