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LONGS DRUGS OF LEXINGTON
FP475012 Pace Community Action Agency, Inc.
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Covered Entity Details
Entity Name
Pace Community Action Agency, Inc.
Subdivision Name
Pace- Health Connection Washington
Type
Family Planning (Title X only)
340B ID
FP475012
Entity Address
2 NE 21ST ST
WASHINGTON, IN 47501
Grant Number
FPHPA006580-03-00
Participating Start Date
1/1/1998
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
1/8/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michelle Pitcher, Clinical Services Director
(812) 882-7927 Ext: 1224
Contract Pharmacy Representative
PMQ Group, LLC dba Avita
Chris Creamer, SVP
(469) 592-2000
Signed By Date
1/8/2025
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