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LONGS DRUGS OF LEXINGTON
RWI19107 ACTIONAIDS dba Action Wellness
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Covered Entity Details
Entity Name
ACTIONAIDS dba Action Wellness
Subdivision Name
Type
Ryan White Part A
340B ID
RWI19107
Entity Address
1216 ARCH STREET
6TH FLOOR
PHILADELPHIA, PA 19107
Grant Number
H89HA00013
Participating Start Date
1/1/2010
Last Recertification Date
2/28/2025
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
10/4/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kevin J. Burns, Executive Director
(215) 981-3338
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
10/4/2021
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