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ADVANCED CARE SCRIPTS, INC
STD890528 LifeCare Partners
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Covered Entity Details
Entity Name
LifeCare Partners
Subdivision Name
NKDHC Southeast Office
Type
Sexually Transmitted Diseases
340B ID
STD890528
Entity Address
861 Coronado Center Dr.
#120
Henderson, NV 89052
Grant Number
NH25PS005179-05-04
Participating Start Date
7/1/2024
Last Recertification Date
Pharmacy Details
Pharmacy Name
ADVANCED CARE SCRIPTS, INC
Pharmacy Address
CVS/SPECIALTY OR CARELONRX SPECIALTY PHA
6251 CHANCELLOR DRIVE
SUITE 101
ORLANDO, FL 32809
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
Central Pharmacy
Abish Thomas, PharmD.
(863) 419-7777
Signed By Date
1/16/2024
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