340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
LONGS DRUGS OF LEXINGTON
STD92914 AIDS Services Foundation Orange County dba Radiant Health Centers
Print
Covered Entity Details
Entity Name
AIDS Services Foundation Orange County dba Radiant Health Centers
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD92914
Entity Address
17982 Sky Park Circle
J
Irvine, CA 92614-6482
Grant Number
NU65PS004745
Participating Start Date
4/1/2019
Last Recertification Date
5/27/2021
Entity Termination Date
10/1/2021
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
4/10/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Guita Sharifi, CFO
(949) 809-5753
Contract Pharmacy Representative
AVITA Pharmacy
JERRY PURCEL, Executive VP
(504) 905-4587
Signed By Date
4/10/2019
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