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LONGS DRUGS OF LEXINGTON
STD331364 University of Miami PrEP Clinic
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Covered Entity Details
Entity Name
University of Miami PrEP Clinic
Subdivision Name
Rapid Access Wellness Clinic
Type
Sexually Transmitted Diseases
340B ID
STD331364
Entity Address
1951 NW 7th ave
480
Miami, FL 33136
Grant Number
6-NU62PS924532-03-02
Participating Start Date
4/1/2020
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
1/18/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/8/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Susanne Doblecki-Lewis, Professor of Clinical Medicine and Chief, Division of Infectious Diseases
(305) 243-7652
Contract Pharmacy Representative
AVITA Pharmacy
JERRY PURCEL, Executive VP
(504) 905-4587
Signed By Date
1/18/2021
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