340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
AVITA PHARMACY 1058
RWI282022 RAO Community Health
Print
Covered Entity Details
Entity Name
RAO Community Health
Subdivision Name
Type
Ryan White Part A
340B ID
RWI282022
Entity Address
321 W 11th St
Charlotte, NC 28202
Grant Number
UT8HA33945
Participating Start Date
3/12/2021
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
AVITA PHARMACY 1058
Pharmacy Address
MEDEXPRESS PHARMACY, LTD. DBA AVITA PHAR
1431 W. INNES ST.
SALISBURY, NC 28144
Pharmacy Comments
Contract Details
Approval Date
3/12/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Akeisha Bardge, CFO/Deputy Director
(704) 237-8793
Contract Pharmacy Representative
Avita/Longs
Veleria Levy, Account Rep.
(704) 293-3504
Signed By Date
3/12/2021
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