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LONGS DRUGS OF LEXINGTON
RWI07601 Buddies of New Jersey, Inc.
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Covered Entity Details
Entity Name
Buddies of New Jersey, Inc.
Subdivision Name
Type
Ryan White Part A
340B ID
RWI07601
Entity Address
149 Hudson Street
Hackensack, NJ 07601
Grant Number
H89HA00026
Participating Start Date
10/1/2013
Last Recertification Date
2/17/2025
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
4/18/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard Miles, Executive Director
(201) 344-4412 Ext: 112
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
4/18/2023
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