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LONGS DRUGS OF LEXINGTON
RWII33807 Harrisonburg Community Health Center
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Covered Entity Details
Entity Name
Harrisonburg Community Health Center
Subdivision Name
Type
Ryan White Part B
340B ID
RWII33807
Entity Address
1380 Little sorrell dr
Harrisonburg, VA 22801
Grant Number
X07HA00009
Participating Start Date
7/1/2018
Last Recertification Date
2/12/2025
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
1/17/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Paloma Saucedo de la Pena, Executive Director
(540) 568-8833
Contract Pharmacy Representative
Avita Pharmacy
JERRY PURCELL, CEO/PRESIDENT
(504) 905-4587
Signed By Date
1/17/2017
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