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AVITA PHARMACY 1040
WellView Care, Inc
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Covered Entity Details
Entity Name
WellView Care, Inc
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
Entity Address
2708 S US HWY 1
Fort Pierce, FL 34982
Grant Number
NH25PS005131
Participating Start Date
Last Recertification Date
Pharmacy Details
Pharmacy Name
AVITA PHARMACY 1040
Pharmacy Address
AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10
6100 CORPORATE BLVD STE 250
BATON ROUGE, LA 70808
Pharmacy Comments
Contract Details
Approval Date
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Adolfo Lorenzo, President
(305) 491-3600
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
4/14/2025
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