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LONGS DRUGS OF LEXINGTON
STD752151 Abounding Prosperity, Inc.
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Covered Entity Details
Entity Name
Abounding Prosperity, Inc.
Subdivision Name
HOPE Health Center
Type
Sexually Transmitted Diseases
340B ID
STD752151
Entity Address
Abounding Prosperity, Inc HOPE Health Center
1619 Martin Luther King Jr. Blvd
Dallas, TX 75215
Grant Number
NU62PS924529
Participating Start Date
10/1/2017
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
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John Moyle, Nurse Practitioner (only monitor 340b database on behalf of CEO Tamara Stephney))
(469) 213-9593
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
7/15/2024
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