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LONGS DRUGS OF LEXINGTON
STD9812231 Gay City Health Project
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Covered Entity Details
Entity Name
Gay City Health Project
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD9812231
Entity Address
400 E Pine St
100
Seattle, WA 98122
Grant Number
NU62PS924528
Participating Start Date
7/1/2020
Last Recertification Date
5/8/2025
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
7/14/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Fred Swanson, Executive Director
(206) 388-1702
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
7/14/2021
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