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GREENBAY SPECIALTY PHARMACY
STD891692 ACCESS Network of Nevada, Inc.
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Covered Entity Details
Entity Name
ACCESS Network of Nevada, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD891692
Entity Address
3483 S Eastern Ave
Suite B
Las Vegas, NV 89169
Grant Number
NH25PS0051790501
Participating Start Date
10/1/2023
Last Recertification Date
5/6/2024
Pharmacy Details
Pharmacy Name
GREENBAY SPECIALTY PHARMACY
Pharmacy Address
3483 S EASTERN AVE STE 100
LAS VEGAS, NV 89169
Pharmacy Comments
Contract Details
Approval Date
8/21/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Juan Rodriguez, Director of 340B Operations
(407) 670-9557
Contract Pharmacy Representative
Greenbay Specialty Pharmacy
Kardam Panjabi, Pharmacy Manager
(419) 408-8840
Signed By Date
7/11/2023
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