340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
AVITA PHARMACY 1058
RWII27604A The Alliance of AIDS Services - Carolina
Print
Covered Entity Details
Entity Name
The Alliance of AIDS Services - Carolina
Subdivision Name
N/A
Type
Ryan White Part B
340B ID
RWII27604A
Entity Address
3109 Poplarwood Ct
Suite 200
Raleigh, NC 27604
Grant Number
X07HA00051
Participating Start Date
7/1/2021
Last Recertification Date
2/12/2025
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
5/28/2021
Contract Begin Date
6/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Melissa J Haithcox-Dennis, 340-B support consultant
(919) 834-2734
Contract Pharmacy Representative
Avita/Longs
Veleria Levy, Account Rep.
(704) 293-3504
Signed By Date
5/28/2021
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