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LONGS DRUGS OF LEXINGTON
RWII29425 MEDICAL UNIVERSITY OF SC INFECTIOUS DISEASES RYAN WHITE PROGRAM
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Covered Entity Details
Entity Name
MEDICAL UNIVERSITY OF SC INFECTIOUS DISEASES RYAN WHITE PROGRAM
Subdivision Name
MUSC Ryan White Program
Type
Ryan White Part B
340B ID
RWII29425
Entity Address
135 Rutledge Ave.
MSC 752
Charleston, SC 29425
Grant Number
X07HA00038
Participating Start Date
4/1/2010
Last Recertification Date
2/11/2025
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
4/12/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Stephen A. Hargett, CFO
(843) 792-6461
Contract Pharmacy Representative
Long's Drugs
Christi Epps, PharmD
(404) 270-9242
Signed By Date
4/12/2016
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