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LONGS DRUGS OF LEXINGTON
STD361111 West Alabama AIDS Outreach
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Covered Entity Details
Entity Name
West Alabama AIDS Outreach
Subdivision Name
Five Horizons Health Services - Wellness Center
Type
Sexually Transmitted Diseases
340B ID
STD361111
Entity Address
3050 McGehee Road
Montgomery, AL 36111
Grant Number
6NH25PS005129-05-05
Participating Start Date
6/15/2023
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
6/15/2023
Contract Begin Date
6/15/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Billy Kirkpatrick, Chief Executive Officer
(205) 759-8470 Ext: 7
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
5/11/2023
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