340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PHARMBLUE LLC DBA AVITA PHARMACY 1059
STD488583 CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT
Print
Covered Entity Details
Entity Name
CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD488583
Entity Address
2012 E. PRESTON STREET
MT. PLEASANT, MI 48858
Grant Number
NH25PS005170
Participating Start Date
4/1/2002
Last Recertification Date
5/7/2025
Pharmacy Details
Pharmacy Name
PHARMBLUE LLC DBA AVITA PHARMACY 1059
Pharmacy Address
1226 CHESTNUT ST
PHILADELPHIA, PA 19107
Pharmacy Comments
Contract Details
Approval Date
4/15/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jaclyn Badger, Health Promotion Director
(989) 773-5921 Ext: 1628
Contract Pharmacy Representative
PMQ Group, LLC dba Avita
Chris Creamer, SVP
(469) 592-2000
Signed By Date
4/15/2024
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