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PHARMBLUE LLC DBA AVITA PHARMACY 1059
STD08701 Family Planning Center of Ocean County
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Covered Entity Details
Entity Name
Family Planning Center of Ocean County
Subdivision Name
DBA LivWell Healthcare
Type
Sexually Transmitted Diseases
340B ID
STD08701
Entity Address
40 Bey Lea Road
Suite B103
Toms River, NJ 08753-2900
Grant Number
NH25PS005174-05-08
Participating Start Date
1/1/2019
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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