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PHARMA BUDDIES CORP
STD89128 Las Vegas Health Center
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Covered Entity Details
Entity Name
Las Vegas Health Center
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD89128
Entity Address
2610 W HORIZON RIDGE PKWY STE
104
Las Vegas, NV 89052
Grant Number
6NH25PS005179-03-05
Participating Start Date
4/20/2022
Last Recertification Date
5/21/2023
Entity Termination Date
7/1/2024
Pharmacy Details
Pharmacy Name
PHARMA BUDDIES CORP
Pharmacy Address
ROSEMONT SPECIALTY PHARMACY
1727 ORLANDO CENTRAL PKWY
ORLANDO, FL 32809
Pharmacy Comments
Contract Details
Approval Date
4/12/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Valerie C Agee, 340B Director
(512) 762-9871
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
4/12/2023
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