340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PHARMBLUE LLC DBA AVITA PHARMACY 1059
STD02118 Multicultural AIDS Coalition
Print
Covered Entity Details
Entity Name
Multicultural AIDS Coalition
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD02118
Entity Address
7 Palmer Street, 3rd Floor
Roxbury, MA 02119
Grant Number
6 NU62PS924700-01-01
Participating Start Date
4/1/2022
Last Recertification Date
5/6/2025
Pharmacy Details
Pharmacy Name
PHARMBLUE LLC DBA AVITA PHARMACY 1059
Pharmacy Address
1226 CHESTNUT ST
PHILADELPHIA, PA 19107
Pharmacy Comments
Contract Details
Approval Date
10/3/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Gary K. Daffin, Executive Director
(617) 840-8604
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
10/3/2022
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