Contract Pharmacy Details

PROCARE PHARMACY DIRECT, L.L.C.
STD89134 Sagebrush Health Services

Covered Entity Details

Entity Name

Sagebrush Health Services

Subdivision Name

Sun City Clinic

Type

Sexually Transmitted Diseases

340B ID

STD89134

Entity Address

9300 Sun City Boulevard
101
Las Vegas, NV 89134

Grant Number

6 NH25PS005179-03-05

Participating Start Date

1/1/2022

Last Recertification Date

6/6/2022

Entity Termination Date

7/1/2023

Pharmacy Details

Pharmacy Name

PROCARE PHARMACY DIRECT, L.L.C.

Pharmacy Address

DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
105 MALL BOULEVARD
MONROEVILLE, PA 15146

Pharmacy Comments

12/11/2009 - PHARMACY MOVED FROM 600 PENN CENTER BLVD., PITTSBURGH, PA 15235-5810 AND NAME CHANGE (WAS PROCARE PHARMACY DIRECT, INC DBA PHARMACARE SPECIALTY PHARMACY)

Contract Details

Approval Date

1/10/2022

Contract Begin Date

4/1/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2023
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

1/10/2022

340B Drug Pricing Program Database