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AVITA PHARMACY 1038
HV00721 The Administrators of the Tulane Educational Fund
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Covered Entity Details
Entity Name
The Administrators of the Tulane Educational Fund
Subdivision Name
Tulane Doctors RW Clinic - Alexandria
Type
Ryan White Part C
340B ID
HV00721
Entity Address
1208 Wisteria Street
Alexandria, LA 71301
Grant Number
H76HA00721
Participating Start Date
10/1/2011
Last Recertification Date
2/12/2025
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
1/15/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
KATHLEEN M. KOZAR, Director, Sponsored projects Administration
(504) 988-5207
Contract Pharmacy Representative
Avita Drugs
JERRY PURCELL, FOUNDER
(504) 905-4587
Signed By Date
1/15/2020
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