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NEVADA CVS PHARMACY, L.L.C.
STD890111 LifeCare Partners
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Covered Entity Details
Entity Name
LifeCare Partners
Subdivision Name
NKDHC Henderson Satellite Office
Type
Sexually Transmitted Diseases
340B ID
STD890111
Entity Address
1051 Wellness Place
#140
Henderson, NV 89011
Grant Number
NH25PS005179-05-04
Participating Start Date
7/1/2024
Last Recertification Date
Pharmacy Details
Pharmacy Name
NEVADA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 08814
2525 S BUFFALO DR
LAS VEGAS, NV 89117
Pharmacy Comments
Contract Details
Approval Date
6/12/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Vladimir Abadjiev, COO
(702) 526-3146
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/16/2024
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