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LONGS DRUGS OF LEXINGTON
STD79401 City of Lubbock
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Covered Entity Details
Entity Name
City of Lubbock
Subdivision Name
Health Department
Type
Sexually Transmitted Diseases
340B ID
STD79401
Entity Address
2015 50th St.
Lubbock, TX 79412
Grant Number
NH25PS005182
Participating Start Date
4/1/2018
Last Recertification Date
5/6/2025
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
7/7/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Katherine Wells, Director of Public Health
(806) 775-2941
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
7/7/2023
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