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LONGS DRUGS OF LEXINGTON
HV12909 THE MCGREGOR CLINIC
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Covered Entity Details
Entity Name
THE MCGREGOR CLINIC
Subdivision Name
Type
Ryan White Part C
340B ID
HV12909
Entity Address
3487 Broadway
FORT MYERS, FL 33901
Grant Number
H76HA12909
Participating Start Date
1/1/2011
Last Recertification Date
2/28/2025
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
7/17/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/22/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
SHARON MURPHY, CEO / DIRECTOR
(239) 334-9555 Ext: 8018
Contract Pharmacy Representative
Avita Pharmacy
Roland Hewitt, Account Executive
(407) 866-3283
Signed By Date
7/17/2018
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