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LONGS DRUGS OF LEXINGTON
STD33880 University of South Florida
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Covered Entity Details
Entity Name
University of South Florida
Subdivision Name
Positively U, Inc.
Type
Sexually Transmitted Diseases
340B ID
STD33880
Entity Address
320 1st Street South
Winter Haven, FL 33880
Grant Number
5H25PS004342
Participating Start Date
7/1/2018
Last Recertification Date
5/13/2025
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
11/13/2021
Contract Begin Date
11/15/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Janet Kitchen, Executive Director
(813) 857-2974
Contract Pharmacy Representative
Avita Pharmacy
Shawn Smith, Account Executive
(305) 906-2937
Signed By Date
11/13/2021
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