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LONGS DRUGS OF LEXINGTON
CH10163Q VALLEY FAMILY HEALTH CARE INC
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Covered Entity Details
Entity Name
VALLEY FAMILY HEALTH CARE INC
Subdivision Name
Valley Family Women and Children Clinic
Type
HRSA-Funded Health Center
340B ID
CH10163Q
Entity Address
840 SW 4th Ave
Ontario, OR 97914-2633
Grant Number
H80CS00556
Participating Start Date
4/1/2024
Last Recertification Date
2/12/2025
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
4/8/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ben Murray, COO
(208) 642-7364
Contract Pharmacy Representative
Avita Drugs
JERRY PURCELL, EVP
(504) 905-4587
Signed By Date
4/8/2024
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