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PHARMA BUDDIES CORP
STD891492 Sagebrush Health Services
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Covered Entity Details
Entity Name
Sagebrush Health Services
Subdivision Name
New Eyes - Centennial Clinic
Type
Sexually Transmitted Diseases
340B ID
STD891492
Entity Address
6850 N Durango Dr
106
Las Vegas, NV 89149
Grant Number
6 NH25PS005179-03-05
Participating Start Date
5/1/2023
Last Recertification Date
5/19/2023
Entity Termination Date
10/1/2023
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
5/1/2023
Contract Begin Date
5/9/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Jami Dybik, Vice President
(843) 814-5177
Contract Pharmacy Representative
Pharma Buddies Corp
Nagesh Shakhamoori, CEO
(877) 592-7988
Signed By Date
4/12/2023
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