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31ST & 3RD PHARMACY INC.
STD100271 START Treatment & Recovery Centers, Inc.
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Covered Entity Details
Entity Name
START Treatment & Recovery Centers, Inc.
Subdivision Name
Starting Point
Type
Sexually Transmitted Diseases
340B ID
STD100271
Entity Address
119 West 124th Street
4th floor
New York, NY 10027
Grant Number
1NU51PS005167-01-00
Participating Start Date
1/1/2022
Last Recertification Date
5/29/2024
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
5/19/2023
Contract Begin Date
5/24/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jonnel C Doris, Chief Executive Officer
(718) 260-2945
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
5/19/2023
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