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TRINITY PHARMACY LLC
STD891491 Sagebrush Health Services
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Covered Entity Details
Entity Name
Sagebrush Health Services
Subdivision Name
Centennial SACI
Type
Sexually Transmitted Diseases
340B ID
STD891491
Entity Address
5550 Painted Mirage Rd
Suite 200
Las Vegas, NV 89149
Grant Number
6 NH25PS005179-05-03
Participating Start Date
5/1/2023
Last Recertification Date
6/4/2024
Entity Termination Date
1/14/2025
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
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
Trinity Care
Sanjay Veerkar, Program Manager
(702) 776-8210
Signed By Date
4/15/2025
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