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AVITA PHARMACY 1044
CHC33642-03 AIDS Action Coalition of Huntsville
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Covered Entity Details
Entity Name
AIDS Action Coalition of Huntsville
Subdivision Name
Thrive Pediatrics
Type
HRSA-Funded Health Center
340B ID
CHC33642-03
Entity Address
3007 Memorial Parkway South
Suite C Unit 2
Huntsville, AL 35801-7420
Grant Number
H80CS33642
Participating Start Date
7/1/2022
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
AVITA PHARMACY 1044
Pharmacy Address
AVITA DRUGS ALABAMA LLC D/B/A AVITA PHAR
3220 5TH AVE S STE 110
BIRMINGHAM, AL 35222-2309
Pharmacy Comments
Contract Details
Approval Date
4/20/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mary Elizabeth Marr, CEO
(256) 337-8283
Contract Pharmacy Representative
Avita
Jeff Paramore, Account Executive
(404) 909-5000
Signed By Date
4/20/2022
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