Contract Pharmacy Details

WARM SPRINGS ROAD CVS, L.L.C.
STD891061 Sagebrush Health Services

Covered Entity Details

Entity Name

Sagebrush Health Services

Subdivision Name

Shadow Lane Neurology

Type

Sexually Transmitted Diseases

340B ID

STD891061

Entity Address

701 Shadow Lane
170
Las Vegas, NV 89106

Grant Number

6 NH25PS005179-05-03

Participating Start Date

1/1/2022

Last Recertification Date

6/11/2024

Entity Termination Date

1/14/2025

Pharmacy Details

Pharmacy Name

WARM SPRINGS ROAD CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 06867
4490 PARADISE RD.
LAS VEGAS, NV 89169

Pharmacy Comments

Contract Details

Approval Date

1/6/2022

Contract Begin Date

4/1/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/14/2025
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Vladimir Abadjiev, Operations Manager
(702) 526-3146

Contract Pharmacy Representative

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

Signed By Date

1/6/2022

340B Drug Pricing Program Database