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PHARMEDQUEST PHARMACY SERVICES
STD922622 Wellness Equity Institute
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Covered Entity Details
Entity Name
Wellness Equity Institute
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD922622
Entity Address
160 North Luring Drive
D
Palm Springs, CA 92262
Grant Number
1H25PS005127
Participating Start Date
7/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
PHARMEDQUEST PHARMACY SERVICES
Pharmacy Address
DBA AVITA PHARMACY 1072
26800 CROWN VALLEY PKWY STE 185
MISSION VIEJO, CA 92691
Pharmacy Comments
Contract Details
Approval Date
4/29/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Marsha Zimmerman, Director
(614) 332-6588
Contract Pharmacy Representative
PMQ Group, LLC dba Avita
Chris Creamer, SVP
(469) 592-2000
Signed By Date
4/11/2025
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