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LONGS DRUGS OF LEXINGTON
RWII48502 Wellness AIDS Services
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Covered Entity Details
Entity Name
Wellness AIDS Services
Subdivision Name
Type
Ryan White Part B
340B ID
RWII48502
Entity Address
311 E. Court St.
Flint, MI 48502
Grant Number
X07HA00044
Participating Start Date
7/1/2021
Last Recertification Date
2/10/2025
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
7/9/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Stevi Atkins, CEO
(810) 232-0888
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
7/9/2021
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