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LONGS DRUGS OF LEXINGTON
STD337103 Help Us Help U Inc.
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Covered Entity Details
Entity Name
Help Us Help U Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD337103
Entity Address
641 49th street north
Saint Petersburg, FL 33710
Grant Number
NH25PS005131
Participating Start Date
12/13/2021
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
9/20/2022
Contract Begin Date
9/20/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/28/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Hemal Dubal, Authorizing Official
(813) 967-3810
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
9/20/2022
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