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PHARMBLUE LLC DBA AVITA PHARMACY 1059
STD03060 City of Nashua
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Covered Entity Details
Entity Name
City of Nashua
Subdivision Name
Division of Public Health and Community Services
Type
Sexually Transmitted Diseases
340B ID
STD03060
Entity Address
18 Mulberry Street
Nashua, NH 03060
Grant Number
1 NH25PS005159-01-00
Participating Start Date
4/1/2013
Last Recertification Date
5/13/2025
Pharmacy Details
Pharmacy Name
PHARMBLUE LLC DBA AVITA PHARMACY 1059
Pharmacy Address
1226 CHESTNUT ST
PHILADELPHIA, PA 19107
Pharmacy Comments
Contract Details
Approval Date
10/14/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bobbie Bagley, Director of Public Health & Community Services
(603) 589-4546
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
10/14/2021
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