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PHARMBLUE LLC DBA AVITA PHARMACY 1059
FP087015 FAMILY PLANNING CENTER OF OCEAN COUNTY, INC.
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Covered Entity Details
Entity Name
FAMILY PLANNING CENTER OF OCEAN COUNTY, INC.
Subdivision Name
DBA LIVWELL HEALTHCARE
Type
Family Planning (Title X only)
340B ID
FP087015
Entity Address
40 Bey Lea Road
Suite B103
Toms River, NJ 08753-2900
Grant Number
FPHPA006527-04-00
Participating Start Date
1/1/1998
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
PHARMBLUE LLC DBA AVITA PHARMACY 1059
Pharmacy Address
1226 CHESTNUT ST
PHILADELPHIA, PA 19107
Pharmacy Comments
Contract Details
Approval Date
4/11/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Darlene Billingham, Chief Operations Officer
(732) 364-9696 Ext: 108
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
4/11/2024
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