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LONGS DRUGS OF LEXINGTON
STD25049 Lotus Healthcare Group LLC
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Covered Entity Details
Entity Name
Lotus Healthcare Group LLC
Subdivision Name
Lotus Recovery Center of Comfort LLC
Type
Sexually Transmitted Diseases
340B ID
STD25049
Entity Address
129 Deanna Street
Comfort, WV 25049
Grant Number
NH25PS005156
Participating Start Date
7/1/2024
Last Recertification Date
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
5/23/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael Mesveskas, Chief Operating Officer
(856) 220-8647
Contract Pharmacy Representative
PMQ Group, LLC dba Avita
Chris Creamer, SVP
(469) 592-2000
Signed By Date
4/13/2024
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