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LONGS DRUGS OF LEXINGTON
CH02371AG INSTITUTE FOR FAMILY HEALTH, THE
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Covered Entity Details
Entity Name
INSTITUTE FOR FAMILY HEALTH, THE
Subdivision Name
Family Health Center of Harlem
Type
HRSA-Funded Health Center
340B ID
CH02371AG
Entity Address
1824 Madison Ave
New York, NY 10035-3832
Grant Number
H80CS00768
Participating Start Date
10/1/2010
Last Recertification Date
2/27/2025
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
4/21/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Caroline DiCioccio, Chief Financial Officer
(212) 633-0800 Ext: 1409
Contract Pharmacy Representative
Avita Pharmacy
Chris Casseri, SVP Sales Acct Mgmt and Marketing
(225) 773-7218
Signed By Date
4/21/2023
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