340B Drug Pricing Program Database

Office of Pharmacy Affairs Logo

AVITA PHARMACY 1018
RWII93291 Source LGBT Center, INC

Covered Entity Details

The Source LGBT+ Center
Ryan White Part B
RWII93291
109 NW 2nd Avenue
Visalia, CA 93291
X07HA12778
4/1/2022
2/10/2025


Pharmacy Details

PHARMEDQUEST PHARMACY SERVICES DBA AVITA
2740 S ELM AVE RM 2
FRESNO, CA 93706-5435

Contract Details

7/14/2022
7/19/2022

7/15/2024
Business decision by covered entity and/or pharmacy


Contacts


Brian Poth, Executive Director
(559) 429-4277 Ext: 8



Avita
Chris Creamer, COO
(469) 592-2000
7/14/2022