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LONGS DRUGS OF LEXINGTON
FP446540 Kno-Ho-Co Ashland Community Action Commission
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Covered Entity Details
Entity Name
Kno-Ho-Co Ashland Community Action Commission
Subdivision Name
Type
Family Planning (Title X only)
340B ID
FP446540
Entity Address
186 West Jackson Street
Millersburg, OH 44654
Grant Number
FPHPA006458
Participating Start Date
10/1/2019
Last Recertification Date
5/5/2025
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
4/17/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
KELLY CORRIGAN, ADMINISTRATOR
(740) 622-9801 Ext: 1030
Contract Pharmacy Representative
PMQ Group, LLC dba Avita
Chris Creamer, SVP
(469) 592-2000
Signed By Date
4/17/2023
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