340B Drug Pricing Program Database

Pharmacy Name

AVITA DRUGS TENESSEE, LLC

Pharmacy Address

DBA AVITA PHARMACY 1050
806 S COOPER ST
STE A
MEMPHIS, TN 38104

Pharmacy Comments

Approval Date

11/17/2019

Contract Begin Date

1/1/2020

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Diane Duke, Executive Director
(901) 333-8240

Contract Pharmacy Representative

Avita Drugs
JERRY PURCELL, EVP
(504) 905-4587

Signed By Date

11/17/2019