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RWI89106 COMMUNITY OUTREACH MEDICAL CENTER (Active)
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Main Details
Name
COMMUNITY OUTREACH MEDICAL CENTER
Subdivision Name
Type
Ryan White Part A
340B ID
RWI89106
Grant Number
H89HA06900
Additional Details
Current Program Status
Active
Registration Date
3/13/2006
Participating Start Date
4/1/2006
Participating Approval Date
3/14/2006
Last Recertification Date
2/13/2025
Time Period the Assistance was Received
10/1/2022 - 5/30/2025
Contacts
Authorizing Official
Community Outreach Medical Center
kema ogden, Executive Director
(702) 604-6052
Primary Contact
Community Outreach Medical Center
Angelica Hall, Operations Director
(702) 657-3873 Ext: 104
Addresses
Street Address
2080 E. Flamingo Rd
Suite 302
Las Vegas, NV 89119
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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3/23/10 ADDR CHANGE (WAS 3603 NO. LAS VEGAS BLVD., SUITE 110) - 01/08/2010 - NEW ADDR (WAS 1440 N. EASTERN AVE. , ZIP 89101) AND ADDED NPI #; 5/29/07 NEW ADDR (WAS 1700 WHEELER PEAK, ZIP 89106)
08/13/2010
April 2025
April 2025
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