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LONGS DRUGS OF LEXINGTON
STD328042 SPEKTRUM Health
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Covered Entity Details
Entity Name
SPEKTRUM Health
Subdivision Name
Orange County Department of Health & Area 7
Type
Sexually Transmitted Diseases
340B ID
STD328042
Entity Address
5205 South Orange Avenue
Suite #110
Orlando, FL 32809
Grant Number
1H25PS005131
Participating Start Date
8/31/2020
Last Recertification Date
5/5/2025
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
10/13/2020
Contract Begin Date
10/20/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/2/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Joseph Anthony Knoll, CEO
(407) 454-1363 Ext: 5001
Contract Pharmacy Representative
Long's Drugs
Ashley Ellis, Corporate Counsel
(803) 254-5884 Ext: 42309
Signed By Date
10/13/2020
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