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LONGS DRUGS OF LEXINGTON
STD30113 HARALSON COUNTY HEALTH DEPARTMENT
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Covered Entity Details
Entity Name
HARALSON COUNTY HEALTH DEPARTMENT
Subdivision Name
DISTRICT 1-1
Type
Sexually Transmitted Diseases
340B ID
STD30113
Entity Address
133 BUCHANNAN BY-PASS
BUCHANAN, GA 30113
Grant Number
NH25PS005184
Participating Start Date
1/1/2000
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
1/10/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Latasha Terry, STD Director
(678) 644-5464
Contract Pharmacy Representative
Avita Drugs
Nick Kersey, Pharmacy Account Executive
(754) 213-6176
Signed By Date
1/10/2023
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