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LONGS DRUGS OF LEXINGTON
STD56262 Southwestern Minnesota Opportunity Council, Inc.
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Covered Entity Details
Entity Name
Southwestern Minnesota Opportunity Council, Inc.
Subdivision Name
SMOC Family Planning
Type
Sexually Transmitted Diseases
340B ID
STD56262
Entity Address
237 N. 2nd St.
Milan, MN 56262
Grant Number
NH25PS005172
Participating Start Date
1/1/2020
Last Recertification Date
5/21/2024
Entity Termination Date
10/1/2024
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
Contract Termination Date
Termination Reason
10/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Neal Steffl, CEO
(507) 376-4195 Ext: 226
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
10/8/2021
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