340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
AVITA PHARMACY 1038
CH062870 EXCELTH, INCORPORATED
Print
Covered Entity Details
Entity Name
EXCELTH, INCORPORATED
Subdivision Name
EXCELTH, INC., HEALTH CARE NETWORK
Type
HRSA-Funded Health Center
340B ID
CH062870
Entity Address
1515 Poydras St
New Orleans, LA 70112-3723
Grant Number
H80CS00129
Participating Start Date
12/1/1992
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
AVITA PHARMACY 1038
Pharmacy Address
AVITA DRUGS LLC-NOLA 2 D/B/A AVITA PHARM
3308 TULANE AVE STE 102
NEW ORLEANS, LA 70119-7170
Pharmacy Comments
Contract Details
Approval Date
6/29/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/1/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
MICHAEL A. ANDRY, CEO
(504) 524-1210 Ext: 4123
Contract Pharmacy Representative
Avita Pharmacy
JERRY PURCELL, CEO/PRESIDENT
(504) 905-4587
Signed By Date
6/29/2016
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session