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31ST & 3RD PHARMACY INC
CHC24175-02 Family and Medical Counseling Service Inc
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Covered Entity Details
Entity Name
Family and Medical Counseling Service Inc
Subdivision Name
FMCS Mobile
Type
HRSA-Funded Health Center
340B ID
CHC24175-02
Entity Address
2041 Martin Luther King Jr Ave SE
Washington, DC 20020-7024
Grant Number
H80CS24175
Participating Start Date
1/1/2023
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
31ST & 3RD PHARMACY INC
Pharmacy Address
D/B/A AVITA PHARMACY 1063
1860 WALT WHITMAN RD STE 700
MELVILLE, NY 11747
Pharmacy Comments
Contract Details
Approval Date
10/16/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Flora Terrell Hamilton, CEO
(202) 889-7900 Ext: 217
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
10/16/2024
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