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PHARMBLUE LLC DBA AVITA PHARMACY 1059
RWI19146 URBAN HEALTH SOLUTIONS INC.
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Covered Entity Details
Entity Name
URBAN HEALTH SOLUTIONS INC.
Subdivision Name
Type
Ryan White Part A
340B ID
RWI19146
Entity Address
1408 S BROAD STREET
FIRST FLOOR
PHILADELPHIA, PA 19146
Grant Number
H89HA00013
Participating Start Date
4/1/2011
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
PHARMBLUE LLC DBA AVITA PHARMACY 1059
Pharmacy Address
1226 CHESTNUT ST
PHILADELPHIA, PA 19107
Pharmacy Comments
Contract Details
Approval Date
7/15/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/7/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Yvonne Jones, Project Director
(215) 755-6462 Ext: 139
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
7/15/2021
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