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31ST & 3RD PHARMACY INC.
STD073051 Healthcare Unity Group Inc
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Covered Entity Details
Entity Name
Healthcare Unity Group Inc
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD073051
Entity Address
405 Kearny Ave
Kearny, NJ 07032
Grant Number
NU62PS924524-05-05
Participating Start Date
6/1/2023
Last Recertification Date
5/8/2024
Pharmacy Details
Pharmacy Name
31ST & 3RD PHARMACY INC.
Pharmacy Address
DBA AVITA PHARMACY 1069
307 W 38TH ST STE 5-013
NEW YORK, NY 10018
Pharmacy Comments
Contract Details
Approval Date
5/25/2023
Contract Begin Date
6/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Anthony John Walko III, Chief Executive Officer
(201) 783-3126
Contract Pharmacy Representative
PMQ Group, LLC dba Avita
Chris Creamer, SVP
(469) 592-2000
Signed By Date
5/11/2023
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