340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ALBERTSON'S LLC
STD891289 Sagebrush Health Services
Print
Covered Entity Details
Entity Name
Sagebrush Health Services
Subdivision Name
Irfan Tahir MD - Desert Mountain
Type
Sexually Transmitted Diseases
340B ID
STD891289
Entity Address
7170 Smoke Ranch Rd
Suite 110
Las Vegas, NV 89128
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
ALBERTSON'S LLC
Pharmacy Address
SAV-ON PHARMACY #0460
11720 W. CHARLESTON BLVD.
LAS VEGAS, NV 89135
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
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
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