Contract Pharmacy Details

ASPCARES
FQHCLA345 FIRST PERSON CARE CLINIC

Covered Entity Details

Entity Name

FIRST PERSON CARE CLINIC

Subdivision Name

First Person Care Clinic

Type

Health Center Program Look-Alike

340B ID

FQHCLA345

Entity Address

1200 S 4TH ST
LAS VEGAS, NV 89104-1046

Grant Number

LALCS00177

Participating Start Date

1/1/2017

Last Recertification Date

2/25/2019

Entity Termination Date

7/1/2019

Pharmacy Details

Pharmacy Name

ASPCARES

Pharmacy Address

501 S RANCHO DR STE G46
LAS VEGAS, NV 89106-4835

Pharmacy Comments

Contract Details

Approval Date

7/5/2017

Contract Begin Date

10/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2019
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Tina Drago, CEO
(702) 380-8118

Contract Pharmacy Representative

American Specialty Pharmacy
Rex Green, Owner
(214) 919-2520

Signed By Date

7/5/2017