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PHARMBLUE LLC DBA AVITA PHARMACY 1059
RWI19146 URBAN HEALTH SOLUTIONS INC.
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Covered Entity Details
Entity Name
URBAN HEALTH SOLUTIONS INC.
Subdivision Name
Type
Ryan White Part A
340B ID
RWI19146
Entity Address
1408 S BROAD STREET
FIRST FLOOR
PHILADELPHIA, PA 19146
Grant Number
H89HA00013
Participating Start Date
4/1/2011
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
PHARMBLUE LLC DBA AVITA PHARMACY 1059
Pharmacy Address
1226 CHESTNUT ST
PHILADELPHIA, PA 19107
Pharmacy Comments
Contract Details
Approval Date
4/7/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/21/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Yvonne Jones, CEO
(215) 755-6462 Ext: 139
Contract Pharmacy Representative
PharmBlue, LLC
Joseph P. Pohl III, CEO
(724) 779-4720 Ext: 033
Signed By Date
4/7/2017
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