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NPS PHARMACY DIRECT
STD23669 LGBT Life Center
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Covered Entity Details
Entity Name
LGBT Life Center
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD23669
Entity Address
20 Settlers Landing
Hampton, VA 23669
Grant Number
5NU62PS924750-04-00
Participating Start Date
1/1/2025
Last Recertification Date
5/26/2025
Pharmacy Details
Pharmacy Name
NPS PHARMACY DIRECT
Pharmacy Address
278 FRANKLIN RD
STE 335
BRENTWOOD, TN 37027
Pharmacy Comments
Contract Details
Approval Date
11/20/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Stacie Walls-Beegle, CEO
(757) 640-0929 Ext: 215
Contract Pharmacy Representative
NPS
John Winnett, Chief Strategy Officer
(615) 831-2291 Ext: 301
Signed By Date
10/15/2024
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