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DSH290007AT UNIVERSITY MEDICAL CENTER OF SOUTHERN NEVADA (Approved)
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Main Details
Name
UNIVERSITY MEDICAL CENTER OF SOUTHERN NEVADA
Subdivision Name
PC @ The Medical District - Primary Care
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH290007AT
Medicare Provider Number
290007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/15/2025
Participating Start Date
7/1/2025
Participating Approval Date
4/30/2025
Last Recertification Date
Contacts
Authorizing Official
University Medical Center of Southern Nevada
Mason Van Houweling, CEO
(702) 383-3862
Primary Contact
University Medical Center of Southern Nevada
Jamie King, Director, Pharmaceutical Services
(702) 383-3791
Addresses
Street Address
1524 Pinto Lane
2nd Floor
Las Vegas, NV 89106
Billing Address
University Medical Center of Southern Nevada
1800 W. Charleston Blvd.
Las Vegas, NV 89102
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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