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LONGS DRUGS OF LEXINGTON
CHC28972-03 AFFINITY HEALTH CENTER
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Covered Entity Details
Entity Name
AFFINITY HEALTH CENTER
Subdivision Name
Catawba Care Fort Mill Site
Type
HRSA-Funded Health Center
340B ID
CHC28972-03
Entity Address
120 ELLIOTT ST E
FORT MILL, SC 29715-1848
Grant Number
H80CS28972
Participating Start Date
1/1/2016
Last Recertification Date
2/23/2021
Entity Termination Date
1/1/2022
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
1/4/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2022
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Anita Case, Executive Director
(803) 909-9710
Contract Pharmacy Representative
Avita Pharmacy
JERRY PURCELL, CEO/PRESIDENT
(504) 905-4587
Signed By Date
1/4/2017
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