Covered Entity Details

DSH290019B CARSON TAHOE REGIONAL HEALTHCARE (Active) - information as of 6/15/2025 6:07:47 AM

Main Details

Name

CARSON TAHOE REGIONAL HEALTHCARE

Subdivision Name

CARSON TAHOE PAIN INSTITUTE - PAIN CLINIC

Type

Disproportionate Share Hospital

Rural

340B ID

DSH290019B

Medicare Provider Number

290019

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

8/15/2024

Participating Start Date

10/1/2024

Participating Approval Date

9/3/2024

Last Recertification Date

Contacts

Authorizing Official

Carson Tahoe Regional Health
Katie Kucera, Chief Financial Officer
(775) 445-8000 Ext: 5543

Primary Contact

Carson Tahoe Regional Health
Andrew P. Batiza, 340B Coordinator
(775) 445-8653

Addresses

Street Address

973 MICA DR 200
CARSON CITY, NV 89705-7258

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
Participating from effective date: (10/012022) until terminated effective date: (10/012023); reinstatement effective date: (10/1/2024)	09/03/2024

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH290019A	Child	DSH	CARSON TAHOE REGIONAL HEALTHCARE	CARSON TAHOE REGIONAL MEDICAL CENTE - BHRS	775 FLEISCHMANN WAY	CARSON CITY	NV	Active
DSH290019B	Child	DSH	CARSON TAHOE REGIONAL HEALTHCARE	CARSON TAHOE PAIN INSTITUTE - PAIN CLINIC	973 MICA DR 200	CARSON CITY	NV	Active
DSH290019C	Child	DSH	CARSON TAHOE REGIONAL HEALTHCARE	CARSON TAHOE REGIONAL MEDICAL CENTE - DAYTON URGENT CARE	901 MEDICAL CENTER DR	DAYTON	NV	Active
DSH290019D	Child	DSH	CARSON TAHOE REGIONAL HEALTHCARE	CARSON TAHOE CARDIOLOGY - CARDIOLOGY	1470 MEDICAL PKWY 140	CARSON CITY	NV	Active
DSH290019E	Child	DSH	CARSON TAHOE REGIONAL HEALTHCARE	CARSON TAHOE REGIONAL MEDICAL CENTE - AIC	1535 MEDICAL PKWY	CARSON CITY	NV	Active
DSH290019F	Child	DSH	CARSON TAHOE REGIONAL HEALTHCARE	CARSON TAHOE REGIONAL MEDICAL CENTE - WOUND CARE	775 FLEISCHMANN WAY	CARSON CITY	NV	Active
DSH290019G	Child	DSH	CARSON TAHOE REGIONAL HEALTHCARE	CARSON TAHOE MINDEN URGENT CARE - MINDEN URGENT CARE	925 IRONWOOD DR	MINDEN	NV	Active
DSH290019H	Child	DSH	CARSON TAHOE REGIONAL HEALTHCARE	CARSON TAHOE REGIONAL MEDICAL CENTE - GREAT BASIN IMAGING	2874 N CARSON ST	CARSON CITY	NV	Active
DSH290019J	Child	DSH	CARSON TAHOE REGIONAL HEALTHCARE	CARSON TAHOE REGIONAL MEDICAL CENTE - AMBULATORY SURGERY CENTER	973 MICA DR	CARSON CITY	NV	Active
DSH290019K	Child	DSH	CARSON TAHOE REGIONAL HEALTHCARE	CARSON TAHOE REGIONAL MEDICAL CENTE - CARSON CITY URGENT CARE	1201 S CARSON ST	CARSON CITY	NV	Active
DSH290019L	Child	DSH	CARSON TAHOE REGIONAL HEALTHCARE	CARSON TAHOE REGIONAL HEALTHCARE - Minden Emergent Care & OP Services imaging	925 Ironwood DRIVE	Minden	NV	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		Approved	Active	10/1/2024 12:01 AM
Contacts	Primary Contact	Update	Reinstatement	Horne, Gary L 340B Coordinator Carson Tahoe Health 7022492353	Batiza, Andrew P. 340B Coordinator Carson Tahoe Regional Health 7754458653	9/3/2024 10:27 AM
Dates	Last Date That 340B Drugs Purchased	Update	Reinstatement	8/21/2023 12:00:00 AM		9/3/2024 10:27 AM
Dates	Participating Approval Date	Update	Reinstatement	9/19/2022 9:13:49 AM	9/3/2024 10:27:32 AM	9/3/2024 10:27 AM
Details	State	Update	Reinstatement	Terminated	Approved	9/3/2024 10:27 AM
Dates	Registration Date	Update	Reinstatement	7/8/2022 6:30:26 PM	8/15/2024 1:15:11 PM	9/3/2024 10:27 AM
Dates	Signed By Date	Update	Reinstatement	9/16/2022 1:30:14 PM	8/30/2024 10:44:40 AM	9/3/2024 10:27 AM
Dates	Start Date	Update	Reinstatement	10/1/2022 12:00:00 AM	10/1/2024 12:00:00 AM	9/3/2024 10:27 AM
Terminations	Termination Date	Update	Reinstatement	10/1/2023 12:00:00 AM		9/3/2024 10:27 AM
Terminations	Termination Effective Date	Update	Reinstatement	8/22/2023 12:00:00 AM		9/3/2024 10:27 AM
Terminations	Termination Reason	Update	Reinstatement	DSH percentage below statutory minimum		9/3/2024 10:27 AM
Details	Comments Public	Insert	Reinstatement		Participating from effective date: (10/012022) until terminated effective date: (10/012023); reinstatement effective date: (10/1/2024)	9/3/2024 10:25 AM
Details	State	Update		To Be Terminated	Terminated	10/1/2023 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Recertification		8/21/2023 12:00:00 AM	8/30/2023 11:02 AM
Details	State	Update	Recertification	Active	To Be Terminated	8/30/2023 11:02 AM
Terminations	Termination Date	Update	Recertification		10/1/2023 12:00:00 AM	8/30/2023 11:02 AM
Terminations	Termination Effective Date	Update	Recertification		8/22/2023 12:00:00 AM	8/30/2023 11:02 AM
Terminations	Termination Reason	Update	Recertification		DSH percentage below statutory minimum	8/30/2023 11:02 AM
Details	State	Update		Approved	Active	10/1/2022 12:01 AM
Contacts	Signed By	Insert	New Registration		Kucera, Katie Chief Financial Officer Carson Tahoe Regional Health 7754458000-5543	9/19/2022 9:13 AM
Details	340B ID	Update	New Registration		DSH290019B	9/19/2022 9:13 AM
Details	Entity Subname	Update	New Registration	CARSON TAHOE PAIN INSTITUTE	CARSON TAHOE PAIN INSTITUTE - PAIN CLINIC	9/19/2022 9:13 AM
Dates	Participating Approval Date	Update	New Registration		9/19/2022 9:13:49 AM	9/19/2022 9:13 AM
Details	State	Update	New Registration	Pending	Approved	9/19/2022 9:13 AM
Dates	Signed By Date	Update	New Registration		9/16/2022 1:30:14 PM	9/19/2022 9:13 AM
Dates	Start Date	Update	New Registration		10/1/2022 12:00:00 AM	9/19/2022 9:13 AM
Addresses	Main Address	Insert	New Registration		973 MICA DR 200 CARSON CITY, NV 89705-7258	7/8/2022 6:30 PM
Contacts	Primary Contact	Insert	New Registration		Horne, Gary L 340B Coordinator Carson Tahoe Health 7022492353	7/8/2022 6:30 PM
Contacts	Authorizing Official	Insert	New Registration		Kucera, Katie Chief Financial Officer Carson Tahoe Regional Health 7754458000-5543	7/8/2022 6:30 PM
Details	Assistance Received From Date	Insert	New Registration			7/8/2022 6:30 PM
Details	Assistance Received To Date	Insert	New Registration			7/8/2022 6:30 PM
Details	Last Recertification Date	Insert	New Registration			7/8/2022 6:30 PM
Details	Grant Number	Insert	New Registration			7/8/2022 6:30 PM
Details	340B ID	Insert	New Registration			7/8/2022 6:30 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			7/8/2022 6:30 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			7/8/2022 6:30 PM
Details	Medicare Provider Number	Insert	New Registration		290019	7/8/2022 6:30 PM
Details	Entity Name	Insert	New Registration		CARSON TAHOE REGIONAL HEALTHCARE	7/8/2022 6:30 PM
Details	NOFO Number	Insert	New Registration			7/8/2022 6:30 PM
Details	Program Code	Insert	New Registration		DSH	7/8/2022 6:30 PM
Details	Entity Subname	Insert	New Registration		CARSON TAHOE PAIN INSTITUTE	7/8/2022 6:30 PM
Dates	Participating Approval Date	Insert	New Registration			7/8/2022 6:30 PM
Details	State	Insert	New Registration		Pending	7/8/2022 6:30 PM
Dates	Registration Date	Insert	New Registration		7/8/2022 6:30:26 PM	7/8/2022 6:30 PM
Dates	Signed By Date	Insert	New Registration			7/8/2022 6:30 PM
Dates	Start Date	Insert	New Registration			7/8/2022 6:30 PM
Terminations	Termination Comments	Insert	New Registration			7/8/2022 6:30 PM
Terminations	Termination Date	Insert	New Registration			7/8/2022 6:30 PM
Terminations	Termination Effective Date	Insert	New Registration			7/8/2022 6:30 PM
Terminations	Termination Reason	Insert	New Registration			7/8/2022 6:30 PM