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TRINITY PHARMACY LLC
STD891494 LifeCare Partners
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Covered Entity Details
Entity Name
LifeCare Partners
Subdivision Name
HMGBD Medical
Type
Sexually Transmitted Diseases
340B ID
STD891494
Entity Address
5550 Painted Mirage Rd.
#1100
Las Vegas, NV 89149
Grant Number
6 NH25PS005179-05-03
Participating Start Date
7/1/2024
Last Recertification Date
Pharmacy Details
Pharmacy Name
TRINITY PHARMACY LLC
Pharmacy Address
TRINITY PHARMACY
2797 S. MARYLAND PKWY., STE 28
LAS VEGAS, NV 89109-8910
Pharmacy Comments
Contract Details
Approval Date
10/15/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Vladimir Abadjiev, COO
(702) 526-3146
Contract Pharmacy Representative
Trinity Pharmacy LLC
Sanjay Veerkar, CEO
(702) 776-8210
Signed By Date
10/15/2024
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