340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
LONGS DRUGS OF LEXINGTON
RWI92653 Shanti Orange County
Print
Covered Entity Details
Entity Name
Shanti Orange County
Subdivision Name
Type
Ryan White Part A
340B ID
RWI92653
Entity Address
23461 South Pointe Drive
Suite 100
Laguna Hills, CA 92653
Grant Number
H89HA00019
Participating Start Date
4/1/2017
Last Recertification Date
2/22/2025
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
4/8/2022
Contract Begin Date
4/13/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lindsay Ann Fitzpatrick, Executive Director
(949) 452-0888 Ext: 9494520888
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
4/8/2022
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session