340B Drug Pricing Program Database

Pharmacy Name

PHARMBLUE LLC DBA AVITA PHARMACY 1059

Pharmacy Address

1226 CHESTNUT ST
PHILADELPHIA, PA 19107

Pharmacy Comments

Approval Date

3/6/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Renee Yandel, Executive Director
(541) 342-5088 Ext: 118

Contract Pharmacy Representative

PharmBlue
Gabriel Santry, Director of National Accounts
(724) 779-4720 Ext: 017

Signed By Date

1/15/2020