340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
AVITA PHARMACY 1029
CH06325AL EL CENTRO DEL BARRIO
Print
Covered Entity Details
Entity Name
EL CENTRO DEL BARRIO
Subdivision Name
CentroMed SA Pediatrics
Type
HRSA-Funded Health Center
340B ID
CH06325AL
Entity Address
123 Stone Oak Loop
San Antonio, TX 78258-3391
Grant Number
H80CS00758
Participating Start Date
10/1/2022
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
AVITA PHARMACY 1029
Pharmacy Address
340B PARTNERS PHARMACY LLC D/B/A AVITA P
303 N FRIO ST
SUITE 102
SAN ANTONIO, TX 78207-3034
Pharmacy Comments
Contract Details
Approval Date
7/8/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ernesto Gomez, President / CEO
(210) 334-3703
Contract Pharmacy Representative
Avita
Taylor Stockett, Strategic Account Executive
(512) 804-8119
Signed By Date
7/8/2024
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