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ALTO PHARMACY, LLC
STD89106 Carewell, Inc. d.b.a. Advancing Health Access of Nevada C2100079
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Covered Entity Details
Entity Name
Carewell, Inc. d.b.a. Advancing Health Access of Nevada C2100079
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD89106
Entity Address
501 South Rancho Drive
I-61
Las Vegas, NV 89106
Grant Number
NH25PS005179-04-00
Participating Start Date
2/1/2021
Last Recertification Date
5/19/2022
Entity Termination Date
4/1/2023
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
1/13/2022
Contract Begin Date
1/19/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Ronald Kooch, COO
(951) 345-3053
Contract Pharmacy Representative
Alto Pharmacy
Neil Joanidhi, Pharmacist
(702) 813-8576
Signed By Date
1/13/2022
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