Contract Pharmacy Details

NEVADA CVS PHARMACY, L.L.C.
STD891065 LifeCare Partners

Covered Entity Details

Entity Name

LifeCare Partners

Subdivision Name

NKDHC Northeast Office

Type

Sexually Transmitted Diseases

340B ID

STD891065

Entity Address

1581 Mount Mariah Dr.
#150
Las Vegas, NV 89106

Grant Number

NH25PS005179-05-04

Participating Start Date

7/1/2024

Last Recertification Date

Entity Termination Date

7/1/2025

Pharmacy Details

Pharmacy Name

NEVADA CVS PHARMACY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 08819
4800 W. CHARLESTON BLVD
LAS VEGAS, NV 89146

Pharmacy Comments

Contract Details

Approval Date

6/12/2024

Contract Begin Date

7/1/2024

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2025
Covered Entity Terminated

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

4/15/2024

340B Drug Pricing Program Database