340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
AVITA PHARMACY 1030
CHC26587-03 SAINT HOPE FOUNDATION
Print
Covered Entity Details
Entity Name
SAINT HOPE FOUNDATION
Subdivision Name
St. Hope Community Health Center Clinic
Type
HRSA-Funded Health Center
340B ID
CHC26587-03
Entity Address
1414 S Frazier St, Ste 105
Conroe, TX 77301
Grant Number
H80CS26587
Participating Start Date
7/1/2017
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
AVITA PHARMACY 1030
Pharmacy Address
6800 WEST LOOP S STE 225
BELLAIRE, TX 77401
Pharmacy Comments
Contract Details
Approval Date
4/17/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Timika Sam-Cooper, Chief Operations Officer
(713) 778-1300 Ext: 2342
Contract Pharmacy Representative
Avita Pharmacy
JERRY PURCELL, CEO/PRESIDENT
(504) 905-4587
Signed By Date
4/17/2017
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