340B Drug Pricing Program Database

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

Approval Date

11/19/2021

Contract Begin Date

1/1/2022

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Richard Zaldivar, Executive Director
(323) 257-1056 Ext: 27

Contract Pharmacy Representative

Avita
Chris Creamer, COO
(469) 592-2000

Signed By Date

10/5/2021