340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
AVITA PHARMACY 1039
STD703012 Life Coast Community Health Center
Print
Covered Entity Details
Entity Name
Life Coast Community Health Center
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD703012
Entity Address
1101 Audubon Ave Ste S-1
Thibodaux, LA 70301
Grant Number
NH25PS005176
Participating Start Date
5/4/2022
Last Recertification Date
5/8/2025
Pharmacy Details
Pharmacy Name
AVITA PHARMACY 1039
Pharmacy Address
1631 ELYSIAN FIELDS AVE STE 200
NEW ORLEANS, LA 70117-8208
Pharmacy Comments
Contract Details
Approval Date
4/26/2022
Contract Begin Date
5/4/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ben Duet, CEO
(985) 492-6170
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
4/11/2022
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