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PRXP OF CA 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
PRXP OF CA LLC
Pharmacy Address
PRXP OF CA LLC
4345 E LOWELL ST
STE C & D
ONTARIO, CA 91761
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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