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LONGS DRUGS OF LEXINGTON
RWI11217 Bridging Access to Care
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Covered Entity Details
Entity Name
Bridging Access to Care
Subdivision Name
Brooklyn AIDS Task Force
Type
Ryan White Part A
340B ID
RWI11217
Entity Address
2261 Church Avenue
Brooklyn, NY 11226
Grant Number
H89HA00015
Participating Start Date
10/1/2013
Last Recertification Date
2/18/2025
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
7/15/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nadine N Akinyemi, Deputy Executive Director
(347) 505-5115
Contract Pharmacy Representative
Avita
Nancy Pandzic, Senior Account Executive
(631) 739-3812
Signed By Date
7/15/2021
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