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LONGS DRUGS OF LEXINGTON
STD029071 Rhode Island Public Health Institute
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Covered Entity Details
Entity Name
Rhode Island Public Health Institute
Subdivision Name
DBA Open Door Health
Type
Sexually Transmitted Diseases
340B ID
STD029071
Entity Address
7-9 Central Street
Providence, RI 02907
Grant Number
NH25PS005160
Participating Start Date
1/1/2020
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
4/11/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lynne Malone, Chief Financial & Administrative Officer
(401) 952-1682
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
4/11/2025
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