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LONGS DRUGS OF LEXINGTON
STD352331 AIDS Alabama, Inc.
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Covered Entity Details
Entity Name
AIDS Alabama, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD352331
Entity Address
2217 6th Avenue South
Birmingham, AL 35233
Grant Number
6NH25PS005129
Participating Start Date
7/1/2019
Last Recertification Date
5/27/2020
Entity Termination Date
4/1/2021
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
4/14/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Kathie Hiers, Chief Executive Officer
(205) 324-9822
Contract Pharmacy Representative
AVITA Pharmacy
JERRY PURCEL, Executive VP
(504) 905-4587
Signed By Date
4/14/2020
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