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LONGS DRUGS OF LEXINGTON
STD37203 Planned Parenthood Greater Memphis Region, DBA Planned Parenthood of Tennessee and North Mississippi
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Covered Entity Details
Entity Name
Planned Parenthood Greater Memphis Region, DBA Planned Parenthood of Tennessee and North Mississippi
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD37203
Entity Address
412 Dr. D.B. Todd, Jr. Blvd.
Nashville, TN 37203
Grant Number
NU65PS923764-01-00
Participating Start Date
1/1/2020
Last Recertification Date
5/22/2025
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
10/7/2024
Contract Begin Date
11/4/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ashley Coffield, CEO
(901) 725-3003
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
10/7/2024
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