340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
AVITA PHARMACY 1038
STD703601 South Louisiana Medical Associates
Print
Covered Entity Details
Entity Name
South Louisiana Medical Associates
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD703601
Entity Address
605 Enterprise Drive Suite B
Houma, LA 70360
Grant Number
NH25PS005176
Participating Start Date
5/3/2022
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
AVITA PHARMACY 1038
Pharmacy Address
AVITA DRUGS LLC-NOLA 2 D/B/A AVITA PHARM
3308 TULANE AVE STE 102
NEW ORLEANS, LA 70119-7170
Pharmacy Comments
Contract Details
Approval Date
4/26/2022
Contract Begin Date
5/3/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Wendy Rotolo, Business office manager
(985) 209-8547
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