Contract Pharmacy Details

ASPCARES
RWI891041 John Phoenix APRN PLLC

Covered Entity Details

Entity Name

John Phoenix APRN PLLC

Subdivision Name

Huntridge Family Clinic/CAN Community Health

Type

Ryan White Part A

340B ID

RWI891041

Entity Address

1820 E. Sahara Ave
Suite 201
Las Vegas, NV 89104

Grant Number

H89HA06900

Participating Start Date

7/1/2022

Last Recertification Date

1/31/2023

Entity Termination Date

1/1/2024

Pharmacy Details

Pharmacy Name

ASPCARES

Pharmacy Address

501 S RANCHO DR STE G46
LAS VEGAS, NV 89106-4835

Pharmacy Comments

Contract Details

Approval Date

1/3/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2021
Covered Entity Terminated

Contacts

Covered Entity Signing Official

John Phoenix, Chief Clinical Officer
(702) 979-1111

Contract Pharmacy Representative

Elite Analytics Group, Inc
Rex Green, CEO
(469) 899-2293

Signed By Date

1/3/2020

340B Drug Pricing Program Database