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LONGS DRUGS OF LEXINGTON
RWII02657A AIDS Support Group of Cape Cod, Inc.
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Covered Entity Details
Entity Name
AIDS Support Group of Cape Cod, Inc.
Subdivision Name
Type
Ryan White Part B
340B ID
RWII02657A
Entity Address
428 South St
Hyannis, MA 02601
Grant Number
X07HA00082
Participating Start Date
7/1/2020
Last Recertification Date
2/28/2025
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
7/8/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Heather Murphy, Chief Programs Officer
(413) 237-5296
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
7/8/2024
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