340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
AVITA PHARMACY 1040
CH06101A MARTIN LUTHER KING JR FAMILY CLINIC INC
Print
Covered Entity Details
Entity Name
MARTIN LUTHER KING JR FAMILY CLINIC INC
Subdivision Name
Foremost Family Health Center - Balch Springs
Type
HRSA-Funded Health Center
340B ID
CH06101A
Entity Address
3515 Shepherd Ln
Balch Springs, TX 75180-2325
Grant Number
H80CS00127
Participating Start Date
1/1/2015
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
AVITA PHARMACY 1040
Pharmacy Address
AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10
6100 CORPORATE BLVD STE 250
BATON ROUGE, LA 70808
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
JOYCE E. TAPLEY, CEO
(469) 601-9360
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
10/16/2023
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session