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PHYSICIAN'S RX PHARMACY, LLC
LifeCare Partners
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Covered Entity Details
Entity Name
LifeCare Partners
Subdivision Name
Infectious Disease Associates
Type
Sexually Transmitted Diseases
340B ID
Entity Address
6088 S. Durango Drive
Suite 100
Las Vegas, NV 89113
Grant Number
NH25PS005179-05-04
Participating Start Date
Last Recertification Date
Pharmacy Details
Pharmacy Name
PHYSICIAN'S RX PHARMACY, LLC
Pharmacy Address
PHYSICIANS RX PHARMACY, LLC
9701 APOLLO DRIVE
#400
LARGO, MD 20774
Pharmacy Comments
Contract Details
Approval Date
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Vladimir Abadjiev, COO
(702) 526-3146
Contract Pharmacy Representative
Physicians Rx Pharmacy of Clinton
Chris Wakefield, Manager
(412) 357-5163
Signed By Date
4/15/2025
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