340B Drug Pricing Program Database
LONGS DRUGS OF LEXINGTON
RWII27604A The Alliance of AIDS Services - Carolina - information as of 5/2/2025 12:31:49 AM
Covered Entity Details
Entity Name
The Alliance of AIDS Services - Carolina
Subdivision Name
N/A
Type
Ryan White Part B
340B ID
RWII27604A
Entity Address
3109 Poplarwood Ct
Suite 200
Raleigh, NC 27604
Grant Number
X07HA00051
Participating Start Date
7/1/2021
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
LONGS DRUGS OF LEXINGTON
Pharmacy Address
D/B/A AVITA PHARMACY 1051
1216 W MAIN ST
STE D
LEXINGTON, SC 29072-2453
Pharmacy Comments
Contract Details
Approval Date
4/2/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tiffany Hickman, Executive Director
(919) 834-2734
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
4/2/2025
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