Contract Pharmacy Details

LONGS DRUGS OF LEXINGTON
STD70002 David L. Schneider, M.D., A.P.M.C.

Covered Entity Details

Entity Name

David L. Schneider, M.D., A.P.M.C.

Subdivision Name

David L. Schneider, M.D. A.P.M.C.

Type

Sexually Transmitted Diseases

340B ID

STD70002

Entity Address

3225 Danny Park, Suite 100
Metairie, LA 70002

Grant Number

NH25PS005176

Participating Start Date

9/22/2022

Last Recertification Date

5/7/2025

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

9/22/2022

Contract Begin Date

9/22/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

6/1/2023
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Adil Aryman Fatakia, MD
(504) 895-5357 Ext: 1

Contract Pharmacy Representative

Avita
Chris Creamer, COO
(469) 592-2000

Signed By Date

9/13/2022

340B Drug Pricing Program Database