340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
LONG'S KILBOURNE ROAD PHARMACY
CHC28972-00 AFFINITY HEALTH CENTER
Print
Covered Entity Details
Entity Name
AFFINITY HEALTH CENTER
Subdivision Name
Affinity Health Center Main Site
Type
HRSA-Funded Health Center
340B ID
CHC28972-00
Entity Address
455 Lakeshore Parkway
Rock Hill, SC 29730-4273
Grant Number
H80CS28972
Participating Start Date
1/1/2016
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
LONG'S KILBOURNE ROAD PHARMACY
Pharmacy Address
D/B/A AVITA PHARMACY 1053
630 KILBOURNE RD
COLUMBIA, SC 29205-2827
Pharmacy Comments
Contract Details
Approval Date
10/5/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/10/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Anita Case, Executive Director
(803) 909-9710
Contract Pharmacy Representative
AVITA Pharmacy
JERRY PURCEL, Executive VP
(504) 905-4587
Signed By Date
10/5/2017
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session