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LONGS DRUGS OF LEXINGTON
FP39097 Plan A Health, Inc
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Covered Entity Details
Entity Name
Plan A Health, Inc
Subdivision Name
Type
Family Planning (Title X only)
340B ID
FP39097
Entity Address
1454 Main Street
Louise, MS 39097
Grant Number
FPHPA006550-01-00
Participating Start Date
10/1/2022
Last Recertification Date
5/9/2024
Entity Termination Date
7/1/2024
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
8/24/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Caroline Weinberg, CEO
(601) 207-3959
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
7/13/2022
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