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AVITA PHARMACY 1029
STD32803 26Health, Inc.
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Covered Entity Details
Entity Name
26Health, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD32803
Entity Address
801 N. Magnolia Ave., Ste 402
Orlando, FL 32803
Grant Number
NH25PS005131
Participating Start Date
10/5/2023
Last Recertification Date
5/7/2025
Pharmacy Details
Pharmacy Name
AVITA PHARMACY 1029
Pharmacy Address
340B PARTNERS PHARMACY LLC D/B/A AVITA P
303 N FRIO ST
SUITE 102
SAN ANTONIO, TX 78207-3034
Pharmacy Comments
Contract Details
Approval Date
10/5/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Syvonne Carter, President and CEO
(321) 800-2922
Contract Pharmacy Representative
avita pharmacy
jeff parramore, account executive
(404) 909-5000
Signed By Date
9/26/2023
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