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LONGS DRUGS OF LEXINGTON
STD701162 NO/AIDS Task Force (d.b.a. CrescentCare)
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Covered Entity Details
Entity Name
NO/AIDS Task Force (d.b.a. CrescentCare)
Subdivision Name
Prevention
Type
Sexually Transmitted Diseases
340B ID
STD701162
Entity Address
1631 ELYSIAN FIELDS AVE
New Orleans, LA 70117
Grant Number
H25PS005176
Participating Start Date
10/1/2013
Last Recertification Date
5/7/2025
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
2/19/2021
Contract Begin Date
2/22/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
NOEL John TWILBECK, CEO
(504) 821-2601 Ext: 1000
Contract Pharmacy Representative
AVITA Pharmacy
JERRY PURCEL, Executive VP
(504) 905-4587
Signed By Date
2/19/2021
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