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LONGS DRUGS OF LEXINGTON
STD328352 Positive Assistance, INC.
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Covered Entity Details
Entity Name
Positive Assistance, INC.
Subdivision Name
Good Health, Inc.
Type
Sexually Transmitted Diseases
340B ID
STD328352
Entity Address
6150 Metrowest Blvd, Suite 202
Orlando, FL 32835
Grant Number
NU62PS924532-02
Participating Start Date
10/1/2020
Last Recertification Date
5/12/2025
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
10/14/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Andre J Antenor, President
(863) 242-3322
Contract Pharmacy Representative
Long's Drugs
Ashley Ellis, Corporate Counsel
(803) 254-5884 Ext: 42309
Signed By Date
10/14/2020
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