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LONGS DRUGS OF LEXINGTON
RWI01420 Making Opportunity Count, Inc.
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Covered Entity Details
Entity Name
Making Opportunity Count, Inc.
Subdivision Name
Type
Ryan White Part A
340B ID
RWI01420
Entity Address
601 River Street
Fitchburg, MA 01420
Grant Number
H89HA00011
Participating Start Date
6/16/2020
Last Recertification Date
2/12/2025
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
1/17/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kevin Reed, Executive Director
(978) 345-7040
Contract Pharmacy Representative
Avita
Jaleesa Smith, 340B Client Services Analyst
(225) 282-2882 Ext: 11058
Signed By Date
1/17/2023
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