340B Drug Pricing Program Database

Pharmacy Name

AVITA PHARMACY 1039

Pharmacy Address

1631 ELYSIAN FIELDS AVE STE 200
NEW ORLEANS, LA 70117-8208

Pharmacy Comments

Approval Date

4/26/2022

Contract Begin Date

5/3/2022

Carve-In Effective Date

Contract Comments

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