340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
AVITA DRUGS FLORIDA, LLC DBA AVITA PHARM
STD33054 Community Life Support
Print
Covered Entity Details
Entity Name
Community Life Support
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33054
Entity Address
486-490 Fisherman Street,
Opalocka, FL 33054
Grant Number
NH25PS004342-04-01
Participating Start Date
1/1/2020
Last Recertification Date
5/9/2025
Pharmacy Details
Pharmacy Name
AVITA DRUGS FLORIDA, LLC DBA AVITA PHARM
Pharmacy Address
8601 COMMODITY CIR, SUITE 105
ORLANDO, FL 32819-9003
Pharmacy Comments
Contract Details
Approval Date
4/13/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
PIERRE R. BLEMUR, M.D.
(305) 688-5456
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
4/13/2022
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