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AVITA PHARMACY 1039
STD70114 New Orleans East Wellness Center
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Covered Entity Details
Entity Name
New Orleans East Wellness Center
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD70114
Entity Address
4023 Behrman Place
Suite M-1
Algiers, LA 70114
Grant Number
NU62PS924522
Participating Start Date
9/22/2022
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
AVITA PHARMACY 1039
Pharmacy Address
1631 ELYSIAN FIELDS AVE STE 200
NEW ORLEANS, LA 70117-8208
Pharmacy Comments
Contract Details
Approval Date
10/31/2022
Contract Begin Date
11/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ronald McLendon, Jr. C McLendon, President/CEO
(504) 615-5981
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
10/31/2022
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