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LONGS DRUGS OF LEXINGTON
STD316341 CLINCH COUNTY HEALTH DEPARTMENT
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Covered Entity Details
Entity Name
CLINCH COUNTY HEALTH DEPARTMENT
Subdivision Name
DISTRICT 9-2
Type
Sexually Transmitted Diseases
340B ID
STD316341
Entity Address
285 SWEAT STREET
HOMERVILLE, GA 31634-2301
Grant Number
NH25PS005184
Participating Start Date
4/1/2014
Last Recertification Date
5/12/2025
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
7/13/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Latasha Terry, STD Director
(678) 644-5464
Contract Pharmacy Representative
AVITA Pharmacy
JERRY PURCEL, Executive VP
(504) 905-4587
Signed By Date
7/13/2023
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