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AVITA PHARMACY 1038
STD70802 Metro Health and Wellness Center
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Covered Entity Details
Entity Name
Metro Health and Wellness Center
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD70802
Entity Address
950 Lorri Burgess Avenue
Baton Rouge, LA 70802
Grant Number
1H25PS062277
Participating Start Date
10/1/2013
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
AVITA PHARMACY 1038
Pharmacy Address
AVITA DRUGS LLC-NOLA 2 D/B/A AVITA PHARM
3308 TULANE AVE STE 102
NEW ORLEANS, LA 70119-7170
Pharmacy Comments
Contract Details
Approval Date
4/1/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Shirley Lolis, Executive Director/CEO
(225) 338-9333
Contract Pharmacy Representative
Avita Pharmacy
Shayla Smith, Strategic Account Executive
(469) 649-9569
Signed By Date
4/1/2024
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