Contract Pharmacy Details

BUDDY'S PHARMACY LLC
STD89027 Sagebrush Health Services

Covered Entity Details

Entity Name

Sagebrush Health Services

Subdivision Name

Mesquite SACI

Type

Sexually Transmitted Diseases

340B ID

STD89027

Entity Address

340 Falcon Ridge Pkwy
#202B
Mesquite, NV 89027

Grant Number

6 NH25PS005179-05-03

Participating Start Date

5/1/2023

Last Recertification Date

6/1/2024

Entity Termination Date

1/14/2025

Pharmacy Details

Pharmacy Name

BUDDY'S PHARMACY LLC

Pharmacy Address

BUDDY'S PHARMACY
3035 S MARYLAND PKWY STE 120
LAS VEGAS, NV 89109-2202

Pharmacy Comments

Contract Details

Approval Date

5/5/2023

Contract Begin Date

5/25/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

6/1/2023
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Jami Dybik, Vice President
(843) 814-5177

Contract Pharmacy Representative

PharmFood Group
Harry Patel, Operations Manager
(973) 362-6086

Signed By Date

5/5/2023

340B Drug Pricing Program Database