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31ST & 3RD PHARMACY INC
FP19111 Newlands Health
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Covered Entity Details
Entity Name
Newlands Health
Subdivision Name
Type
Family Planning (Title X only)
340B ID
FP19111
Entity Address
6447-49 Rising Sun Avenue
Philadelphia, PA 19111
Grant Number
FPHPA006433
Participating Start Date
7/1/2023
Last Recertification Date
5/31/2024
Pharmacy Details
Pharmacy Name
31ST & 3RD PHARMACY INC
Pharmacy Address
D/B/A AVITA PHARMACY 1063
1860 WALT WHITMAN RD STE 700
MELVILLE, NY 11747
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Helena Kwakwa, Medical Director
(215) 941-1236
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
10/16/2023
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