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LONGS DRUGS OF LEXINGTON
STD488583 CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT
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Covered Entity Details
Entity Name
CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD488583
Entity Address
2012 E. PRESTON STREET
MT. PLEASANT, MI 48858
Grant Number
NH25PS005170
Participating Start Date
4/1/2002
Last Recertification Date
5/7/2025
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
4/15/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jaclyn Badger, Health Promotion Director
(989) 773-5921 Ext: 1628
Contract Pharmacy Representative
PMQ Group, LLC dba Avita
Chris Creamer, SVP
(469) 592-2000
Signed By Date
4/15/2024
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