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LONGS DRUGS OF LEXINGTON
HV01706A MEHARRY COMMUNITY WELLNESS CENTER
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Covered Entity Details
Entity Name
MEHARRY COMMUNITY WELLNESS CENTER
Subdivision Name
METROPOLITAN INTERDENOMINOTIONAL CHURCH/FIRST RESPONSE CENTER
Type
Ryan White Part C
340B ID
HV01706A
Entity Address
2128 11th avenue North
NASHVILLE, TN 37208
Grant Number
H76HA01706
Participating Start Date
9/10/2021
Last Recertification Date
2/26/2025
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
10/8/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
VLADIMIR BERTHAUD, EXECUTIVE DIRECTOR
(615) 327-5753
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
10/8/2021
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