340B Drug Pricing Program Database

Pharmacy Name

PHARMBLUE LLC DBA AVITA PHARMACY 1059

Pharmacy Address

1226 CHESTNUT ST
PHILADELPHIA, PA 19107

Pharmacy Comments

Approval Date

6/15/2023

Contract Begin Date

6/15/2023

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Editha Paras, Interim Chief Executive Officer
(773) 472-6469

Contract Pharmacy Representative

Avita
Chris Creamer, COO
(469) 592-2000

Signed By Date

4/7/2023