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LONGS DRUGSTORES OF SC INC
CHC28972-00 AFFINITY HEALTH CENTER
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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
LONGS DRUGSTORES OF SC INC
Pharmacy Address
D/B/A AVITA PHARMACY 1054
455 LAKESHORE PKWY
ROCK HILL, SC 29730-4205
Pharmacy Comments
Contract Details
Approval Date
4/12/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Anita Case, Executive Director
(803) 909-9710
Contract Pharmacy Representative
Avita Drugs
JERRY PURCELL, EVP
(504) 905-4587
Signed By Date
4/12/2018
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