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LONGS DRUGS OF LEXINGTON
STD331422 New Horizons Community Mental Health Center, Inc.
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Covered Entity Details
Entity Name
New Horizons Community Mental Health Center, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD331422
Entity Address
1499 NW 36th Street
Miami, FL 33142
Grant Number
5NU62PS924532-02
Participating Start Date
1/1/2020
Last Recertification Date
5/6/2025
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
11/30/2021
Contract Begin Date
11/30/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jerry Rodriguez, Chief of Operations
(305) 506-5219
Contract Pharmacy Representative
Avita Drugs
JERRY PURCELL, EVP
(504) 905-4587
Signed By Date
11/30/2021
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