340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
LONG'S KILBOURNE ROAD PHARMACY
STD292032 University of South Carolina School of Medicine Educational Trust
Print
Covered Entity Details
Entity Name
University of South Carolina School of Medicine Educational Trust
Subdivision Name
Department of Internal Medicine
Type
Sexually Transmitted Diseases
340B ID
STD292032
Entity Address
1 Richland Medical Park, Suite 420
Columbia, SC 29203
Grant Number
1NH25PS005150-01-00
Participating Start Date
1/1/2018
Last Recertification Date
5/22/2019
Entity Termination Date
10/1/2019
Pharmacy Details
Pharmacy Name
LONG'S KILBOURNE ROAD PHARMACY
Pharmacy Address
D/B/A AVITA PHARMACY 1053
630 KILBOURNE RD
COLUMBIA, SC 29205-2827
Pharmacy Comments
Contract Details
Approval Date
7/16/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Bernard Gilliard, Program Manager - DIS and Partner Services
(803) 898-0452
Contract Pharmacy Representative
Long's Drugs
Christi Epps, PharmD
(404) 270-9242
Signed By Date
7/16/2018
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