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LONGS DRUGS OF LEXINGTON
STD33307 Arianna's Center
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Covered Entity Details
Entity Name
Arianna's Center
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33307
Entity Address
2501 NE 30th St.
Fort Lauderdale, FL 33306
Grant Number
NH25PS005131
Participating Start Date
10/1/2022
Last Recertification Date
5/9/2025
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
10/13/2022
Contract Begin Date
11/16/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Arianna Inurritegui-Lint, CEO - FOUNDER
(786) 600-1915
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
10/13/2022
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