340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
NPS PHARMACY AT ETSU
STD235101 LGBT Life Center
Print
Covered Entity Details
Entity Name
LGBT Life Center
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD235101
Entity Address
5360 Robin Hood Rd
Suite 200
Norfolk, VA 23513
Grant Number
NU62PS924552
Participating Start Date
4/1/2017
Last Recertification Date
6/4/2024
Entity Termination Date
7/1/2024
Pharmacy Details
Pharmacy Name
NPS PHARMACY AT ETSU
Pharmacy Address
615 N STATE OF FRANKLIN RD
JOHNSON CITY, TN 37604-8209
Pharmacy Comments
Contract Details
Approval Date
4/14/2020
Contract Begin Date
4/22/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Stacie Walls-Beegle, CEO
(757) 640-0929 Ext: 215
Contract Pharmacy Representative
NPS Pharmacy
Kevin Hartman, Pharm D
(615) 371-1210 Ext: 311
Signed By Date
4/14/2020
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