340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
AVITA PHARMACY 1028
PED193300-00 Children's Hospital
Print
Covered Entity Details
Entity Name
Children's Hospital
Subdivision Name
Type
Children's Hospital
340B ID
PED193300-00
Entity Address
200 HENRY CLAY AVENUE
NEW ORLEANS, LA 70118
Medicare Provider Number
193300
Participating Start Date
1/1/2014
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
AVITA PHARMACY 1028
Pharmacy Address
340B PARTNERS PHARMACY-DALLAS LLC DBA AV
750 FORT WORTH AVE STE H100
DALLAS, TX 75208-1811
Pharmacy Comments
Contract Details
Approval Date
7/16/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/14/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Mary Perrin, CEO
(504) 896-9452
Contract Pharmacy Representative
Avita Drugs
JERRY PURCELL, FOUNDER
(504) 905-4587
Signed By Date
7/16/2014
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