Contract Pharmacy Details

LIFECARE PHARMACY, LLC
CHC31240-00 FIRST PERSON CARE CLINIC

Covered Entity Details

Entity Name

FIRST PERSON CARE CLINIC

Subdivision Name

First Person Care Clinic

Type

HRSA-Funded Health Center

340B ID

CHC31240-00

Entity Address

1200 S 4TH ST
111
LAS VEGAS, NV 89104-1046

Grant Number

H80CS31240

Participating Start Date

4/1/2018

Last Recertification Date

2/25/2025

Pharmacy Details

Pharmacy Name

LIFECARE PHARMACY, LLC

Pharmacy Address

DBA: LIFECARE PHARMACY
3050 E. DESERT INN RD.
STE#124
LAS VEGAS, NV 89121-3873

Pharmacy Comments

Contract Details

Approval Date

10/15/2019

Contract Begin Date

1/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/15/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Roxana Valeton, CEO
(305) 303-8108

Contract Pharmacy Representative

LifeCare Specialty Pharmacy
CLETUS AMADI, Owner
(702) 697-2105

Signed By Date

10/15/2019

340B Drug Pricing Program Database