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PRIME THERAPEUTICS SPECIALTY PHARMACY LL
STD871023 UNM Truman Health Services
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Covered Entity Details
Entity Name
UNM Truman Health Services
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD871023
Entity Address
801 Encino Place NE Building A6
Albuquerque, NM 87102
Grant Number
NH25PS005180
Participating Start Date
7/1/2021
Last Recertification Date
5/6/2024
Pharmacy Details
Pharmacy Name
PRIME THERAPEUTICS SPECIALTY PHARMACY LL
Pharmacy Address
ALLIANCERX WALGREENS PRIME #16568
2354 COMMERCE PARK DRIVE
SUITE 100
ORLANDO, FL 32819-9992
Pharmacy Comments
Contract Details
Approval Date
10/14/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/14/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jill C. Klar, Chief Operating Officer
(505) 301-8069
Contract Pharmacy Representative
Truman
Sam Sanchez, Director, Pharmacy Services
(505) 925-0988
Signed By Date
10/14/2021
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