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OPTIMED SPECIALTY PHARMACY
STD891132 Sagebrush Health Services
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Covered Entity Details
Entity Name
Sagebrush Health Services
Subdivision Name
Battleborn Health Care
Type
Sexually Transmitted Diseases
340B ID
STD891132
Entity Address
8379 W Sunset Rd
Suite 210
Las Vegas, NV 89113
Grant Number
NH25PS005179
Participating Start Date
10/1/2023
Last Recertification Date
6/12/2025
Pharmacy Details
Pharmacy Name
OPTIMED SPECIALTY PHARMACY
Pharmacy Address
6480 TECHNOLOGY AVE STE A
KALAMAZOO, MI 49009
Pharmacy Comments
Contract Details
Approval Date
4/13/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/5/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jami Dybik, Vice President
(843) 814-5177
Contract Pharmacy Representative
OptiMed Health Partners, Inc.
Matthew Sortland, Manager, Business Development
(269) 250-8013
Signed By Date
4/13/2024
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