Contract Pharmacy Details

LONGS DRUGS OF LEXINGTON
HV00657 Roper St. Francis Healthcare

Covered Entity Details

Entity Name

Roper St. Francis Healthcare

Subdivision Name

Roper St. Francis Health Services Center

Type

Ryan White Part C

340B ID

HV00657

Entity Address

1481 Tobias Gadson Blvd, Suite 1
CHARLESTON, SC 29407

Grant Number

H76HA31742

Participating Start Date

7/1/2007

Last Recertification Date

2/10/2025

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

4/11/2016

Contract Begin Date

7/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/30/2022
Pharmacy closed

Contacts

Covered Entity Signing Official

Kimberly Butler Willis, RW PROGRAM DIRECTOR
(843) 402-1067

Contract Pharmacy Representative

Long's Drugs
Christi Epps, PharmD
(404) 270-9242

Signed By Date

4/11/2016

340B Drug Pricing Program Database