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LONGS DRUGS OF LEXINGTON
FP131142 OSWEGO COUNTY OPPORTUNITIES INC.
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Covered Entity Details
Entity Name
OSWEGO COUNTY OPPORTUNITIES INC.
Subdivision Name
Mexico Center for Reproductive Health
Type
Family Planning (Title X only)
340B ID
FP131142
Entity Address
5856 SCENIC AVENUE
MEXICO, NY 13114
Grant Number
FPHPA006409
Participating Start Date
1/1/2024
Last Recertification Date
5/6/2024
Entity Termination Date
4/1/2025
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
10/27/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Leanna K Cleveland, Director of Health & Nutrition Services
(315) 529-8329
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
10/26/2023
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