340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
AVITA PHARMACY 1029
RWII77301 ST. HOPE FOUNDATION, INC.
Print
Covered Entity Details
Entity Name
ST. HOPE FOUNDATION, INC.
Subdivision Name
Type
Ryan White Part B
340B ID
RWII77301
Entity Address
1414 SOUTH FRAZIER #105/106
CONROE, TX 77301
Grant Number
T2-TX
Participating Start Date
4/1/2009
Last Recertification Date
2/14/2020
Entity Termination Date
1/1/2021
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
12/17/2012
Contract Begin Date
1/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Timika Sam-Cooper, Chief Operations Officer
(713) 778-1300 Ext: 2342
Contract Pharmacy Representative
Avita Drugs
KEITH FOX, CFO
(225) 236-1540
Signed By Date
10/15/2012
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