Contract Pharmacy Details

NEVADA CVS PHARMACY, L.L.C.
STD891061 Sagebrush Health Services

Covered Entity Details

Entity Name

Sagebrush Health Services

Subdivision Name

Shadow Lane Neurology

Type

Sexually Transmitted Diseases

340B ID

STD891061

Entity Address

701 Shadow Lane
170
Las Vegas, NV 89106

Grant Number

6 NH25PS005179-05-03

Participating Start Date

1/1/2022

Last Recertification Date

6/11/2024

Entity Termination Date

1/14/2025

Pharmacy Details

Pharmacy Name

NEVADA CVS PHARMACY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 00121
1402 E. LAKE MEAD PKWY.
HENDERSON, NV 89015

Pharmacy Comments

Contract Details

Approval Date

Contract Begin Date

7/1/2025

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Mithila Urs, Director
(714) 797-8666

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

4/15/2025

340B Drug Pricing Program Database