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AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10
RWI782071 Alamo Area Resource Center
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Covered Entity Details
Entity Name
Alamo Area Resource Center
Subdivision Name
Type
Ryan White Part A
340B ID
RWI782071
Entity Address
303 N. Frio
San Antonio, TX 78207
Grant Number
H89HA31891
Participating Start Date
1/1/2013
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10
Pharmacy Address
6406 MCPHERSON RD STE 6
LAREDO, TX 78041
Pharmacy Comments
Contract Details
Approval Date
6/10/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/9/2023
Agreement registered in error
Contacts
Covered Entity Signing Official
Jose Cervantes, Executive Director
(210) 625-7193 Ext: 7193
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
6/10/2023
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