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LEE KING PHARMACY
STD303311 Sisterlove Inc.
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Covered Entity Details
Entity Name
Sisterlove Inc.
Subdivision Name
Sisterlove Inc.
Type
Sexually Transmitted Diseases
340B ID
STD303311
Entity Address
3709 Bakers Ferry Road SW
Atlanta, GA 30331
Grant Number
NH25PS005184
Participating Start Date
1/1/2019
Last Recertification Date
6/4/2024
Pharmacy Details
Pharmacy Name
LEE KING PHARMACY
Pharmacy Address
18 CAVENDER ST
NEWNAN, GA 30263-1932
Pharmacy Comments
Contract Details
Approval Date
4/13/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Dazon Dixon Diallo, Founder/President
(404) 505-7777
Contract Pharmacy Representative
LEE KING PHARMACY
Mindy Leech, PharmD
(770) 253-1622
Signed By Date
4/13/2025
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