Contract Pharmacy Details

ASTIS WASHINGTON PHARMACY
STD15301 Central Outreach Wellness Center, LLC

Covered Entity Details

Entity Name

Central Outreach Wellness Center, LLC

Subdivision Name

Central Outreach Wellness Center, LLC South Office

Type

Sexually Transmitted Diseases

340B ID

STD15301

Entity Address

817 Jefferson Avenue
Washington, PA 15301

Grant Number

NH25PS005144

Participating Start Date

4/1/2018

Last Recertification Date

5/7/2024

Pharmacy Details

Pharmacy Name

ASTIS WASHINGTON PHARMACY

Pharmacy Address

817 JEFFERSON AVE
SUITE 101
WASHINGTON, PA 15301

Pharmacy Comments

Contract Details

Approval Date

1/7/2022

Contract Begin Date

4/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Stacy Lane, Owner
(412) 608-8313

Contract Pharmacy Representative

Asti's Pharmacy
Samantha Pitzarella, Director of Operations
(412) 561-2503

Signed By Date

1/7/2022

340B Drug Pricing Program Database