Contract Pharmacy Details

AVG, INC.
STD331395 Folx Foundation, Inc.

Covered Entity Details

Entity Name

Folx Foundation, Inc.

Subdivision Name

Type

Sexually Transmitted Diseases

340B ID

STD331395

Entity Address

407 Lincoln Road
Suite 6-B
Miami Beach, FL 33139

Grant Number

H25PS005131

Participating Start Date

9/23/2022

Last Recertification Date

5/5/2025

Pharmacy Details

Pharmacy Name

AVG, INC.

Pharmacy Address

ADVANCECARE PHARMACY
8700 SANTA MONICA BLVD.
WEST HOLLYWOOD, CA 90069

Pharmacy Comments

Contract Details

Approval Date

4/5/2023

Contract Begin Date

4/6/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/6/2023
Agreement registered in error

Contacts

Covered Entity Signing Official

Katie Runnells, Director
(310) 466-0897

Contract Pharmacy Representative

AdvanceCare Pharmacy
Kyle Bernier, Director of Operations
(508) 971-8380

Signed By Date

4/5/2023

340B Drug Pricing Program Database