340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
AVITA PHARMACY 1047
CH04023M Agape Community Health Center, Inc.
Print
Covered Entity Details
Entity Name
Agape Community Health Center, Inc.
Subdivision Name
Agape Dunn Avenue
Type
HRSA-Funded Health Center
340B ID
CH04023M
Entity Address
1680 Dunn Ave Unit 35-37
Jacksonville, FL 32218-4782
Grant Number
H80CS29456
Participating Start Date
10/1/2020
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
AVITA PHARMACY 1047
Pharmacy Address
AVITA DRUGS FLORIDA LLC D/B/A AVITA PHAR
801 N MAGNOLIA AVE STE 406
ORLANDO, FL 32803-3843
Pharmacy Comments
Contract Details
Approval Date
7/15/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tabatha Ball, COO
(904) 760-4904
Contract Pharmacy Representative
Avita Pharmacy
Roland Hewitt, Account Executive
(407) 866-3283
Signed By Date
7/15/2021
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