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LONGS DRUGS OF LEXINGTON
STD562831 Southwestern Minnesota Opportunity Council, Inc.
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Covered Entity Details
Entity Name
Southwestern Minnesota Opportunity Council, Inc.
Subdivision Name
Carris Health, LLC (D/B/A) CentraCare-Redwood
Type
Sexually Transmitted Diseases
340B ID
STD562831
Entity Address
101 Caring Way
Redwood Falls, MN 56283
Grant Number
NH25PS005172
Participating Start Date
1/1/2022
Last Recertification Date
5/5/2025
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
11/3/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
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
10/11/2021
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