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CAREMARK, L.L.C.
STD891184 LifeCare Partners
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Covered Entity Details
Entity Name
LifeCare Partners
Subdivision Name
NKDHC Southwest Office
Type
Sexually Transmitted Diseases
340B ID
STD891184
Entity Address
5815 S Rainbow Blvd.
#110
Las Vegas, NV 89118
Grant Number
NH25PS005179-05-04
Participating Start Date
7/1/2024
Last Recertification Date
Pharmacy Details
Pharmacy Name
CAREMARK, L.L.C.
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
7251 S. EASTERN AVE.
LAS VEGAS, NV 89119
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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