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LONGS DRUGS OF LEXINGTON
STD78721 Center for Health Empowerment
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Covered Entity Details
Entity Name
Center for Health Empowerment
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD78721
Entity Address
2312 Western Trails Blvd
Ste 103
Austin, TX 78745
Grant Number
NH25PS005182
Participating Start Date
7/1/2018
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
1/13/2021
Contract Begin Date
1/18/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Scott Lyles, Board Chair
(512) 608-7298
Contract Pharmacy Representative
Long's Drugs
Ashley Ellis, Corporate Counsel
(803) 254-5884 Ext: 42309
Signed By Date
1/13/2021
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