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LONGS DRUGS OF LEXINGTON
STD122061 AIDS Council of Northeastern New York
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Covered Entity Details
Entity Name
AIDS Council of Northeastern New York
Subdivision Name
Alliance for Positive Health
Type
Sexually Transmitted Diseases
340B ID
STD122061
Entity Address
845 Central Avenue
Suite 202
Albany, NY 12206
Grant Number
6NH25PS005175
Participating Start Date
10/1/2024
Last Recertification Date
5/5/2025
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
9/16/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bowman Kim Atkins, Executive Director
(518) 434-4686 Ext: 2431
Contract Pharmacy Representative
Avita
Shawn Smith, Sr Account Executive
(305) 906-2937
Signed By Date
9/16/2024
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