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ALTO PHARMACY, LLC
RW489106 UNLV
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Covered Entity Details
Entity Name
UNLV
Subdivision Name
UNLV Medicine
Type
Ryan White Part D
340B ID
RW489106
Entity Address
1524 Pinto Lane
Las Vegas, NV 89106
Grant Number
H12HA30109
Participating Start Date
1/1/2020
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
ALTO PHARMACY, LLC
Pharmacy Address
DBA ALTO PHARMACY
1400 TENNESSEE ST UNIT 2
SAN FRANCISCO, CA 94107-3421
Pharmacy Comments
Contract Details
Approval Date
10/27/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/13/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Julie Young, VP Business Operations and Dtrategy
(702) 333-1530
Contract Pharmacy Representative
Alto Pharmacy
Jaime LaFontaine, Director of Enterprise
(916) 539-4587
Signed By Date
10/27/2021
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