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AVITA DRUGS FLORIDA, LLC DBA AVITA PHARM
STD328093 Embrace Health, Inc.
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Covered Entity Details
Entity Name
Embrace Health, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD328093
Entity Address
6220 South Orange Blossom Trail
Suite 602
Orlando, FL 32809
Grant Number
1H25PS005131
Participating Start Date
10/1/2022
Last Recertification Date
5/5/2025
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
8/11/2022
Contract Begin Date
8/18/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Vickie L. Cobb-Lucien, Mrs.
(407) 259-4307
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
7/2/2022
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