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LONGS DRUGS OF LEXINGTON
CHC24107-00 GENESIS COMMUNITY HEALTH, INC.
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Covered Entity Details
Entity Name
GENESIS COMMUNITY HEALTH, INC.
Subdivision Name
Genesis Community Health
Type
HRSA-Funded Health Center
340B ID
CHC24107-00
Entity Address
709 South Federal Hwy
Suite 3
Boynton Beach, FL 33435-6033
Grant Number
H80CS24107
Participating Start Date
10/1/2012
Last Recertification Date
2/10/2025
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
10/15/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/13/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
DeAnna Warren, Executive Director
(561) 806-6835 Ext: 201
Contract Pharmacy Representative
Avita Pharmacy
Shawn Smith, Account Executive
(305) 906-2937
Signed By Date
10/15/2019
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