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WARM SPRINGS ROAD CVS, L.L.C.
STD89011 Sagebrush Health Services
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Covered Entity Details
Entity Name
Sagebrush Health Services
Subdivision Name
Henderson Satellite Clinic - NKDHC
Type
Sexually Transmitted Diseases
340B ID
STD89011
Entity Address
1051 Wellness Place
#140
Henderson, NV 89011
Grant Number
6 NH25PS005179-05-02
Participating Start Date
11/29/2022
Last Recertification Date
5/22/2023
Entity Termination Date
4/1/2024
Pharmacy Details
Pharmacy Name
WARM SPRINGS ROAD CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 04784
3270 S. BUFFALO DR.
LAS VEGAS, NV 89117
Pharmacy Comments
Contract Details
Approval Date
11/29/2022
Contract Begin Date
12/15/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2024
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
10/17/2022
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