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LONGS DRUGS OF LEXINGTON
STD30680 BARROW COUNTY HEALTH DEPARTMENT
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Covered Entity Details
Entity Name
BARROW COUNTY HEALTH DEPARTMENT
Subdivision Name
DISTRICT 10
Type
Sexually Transmitted Diseases
340B ID
STD30680
Entity Address
15 PORTER STREET EAST
WINDER, GA 30680
Grant Number
NH25PS005184
Participating Start Date
1/1/2000
Last Recertification Date
5/6/2025
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
10/15/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Latasha Terry, STD Director
(678) 644-5464
Contract Pharmacy Representative
AVITA Pharmacy
JERRY PURCEL, Executive VP
(504) 905-4587
Signed By Date
10/15/2020
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