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LONGS DRUGS OF LEXINGTON
STD83702 Allies Linked for the Prevention of HIV and AIDS
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Covered Entity Details
Entity Name
Allies Linked for the Prevention of HIV and AIDS
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD83702
Entity Address
537 W Bannock St
Suite 100
Boise, ID 83702
Grant Number
H25PS004321
Participating Start Date
4/1/2018
Last Recertification Date
5/15/2025
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
6/15/2022
Contract Begin Date
6/16/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christopher Scott Bidiman, Executive Director
(208) 424-7799 Ext: 402
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
6/15/2022
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