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LONGS DRUGS OF LEXINGTON
STD352221 AIDS Alabama, Inc.
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Covered Entity Details
Entity Name
AIDS Alabama, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD352221
Entity Address
3532 7th Court South
Birmingham, AL 35222
Grant Number
5NH25PS005129-03-00
Participating Start Date
1/1/2018
Last Recertification Date
5/11/2023
Entity Termination Date
7/1/2024
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
7/1/2024
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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