340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO.
STD890181 Sagebrush Health Services
Print
Covered Entity Details
Entity Name
Sagebrush Health Services
Subdivision Name
Total Family Care Specialists - Desert Mountain
Type
Sexually Transmitted Diseases
340B ID
STD890181
Entity Address
3280 N Rainbow Blvd
Suite 110
Las Vegas, NV 89018
Grant Number
6 NH25PS005179-05-03
Participating Start Date
10/1/2023
Last Recertification Date
6/11/2024
Entity Termination Date
1/1/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #11668
6390 BOULDER HWY.
LAS VEGAS, NV 89122
Pharmacy Comments
Contract Details
Approval Date
10/29/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Jami Dybik, Vice President
(843) 814-5177
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/29/2023
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session