Contract Pharmacy Details

NEVADA CVS PHARMACY, L.L.C.
CHC30721-01 Silver State Health Services

Covered Entity Details

Entity Name

Silver State Health Services

Subdivision Name

Silver State Health Services- Renaissance

Type

HRSA-Funded Health Center

340B ID

CHC30721-01

Entity Address

2215 Renaissance Dr Ste C
Las Vegas, NV 89119-6729

Grant Number

H80CS30721

Participating Start Date

7/22/2020

Last Recertification Date

3/6/2023

Entity Termination Date

4/1/2024

Pharmacy Details

Pharmacy Name

NEVADA CVS PHARMACY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 08808
2011 E. LAKE MEAD BLVD
NORTH LAS VEGAS, NV 89030

Pharmacy Comments

Contract Details

Approval Date

7/22/2020

Contract Begin Date

7/22/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2024
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Ryan Linden, CEO
(702) 937-3418

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

7/2/2020

340B Drug Pricing Program Database