340B Drug Pricing Program Database

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

Approval Date

5/25/2023

Contract Begin Date

6/1/2023

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Anthony John Walko III, Chief Executive Officer
(201) 783-3126

Contract Pharmacy Representative

PMQ Group, LLC dba Avita
Chris Creamer, SVP
(469) 592-2000

Signed By Date

5/11/2023