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DSH290007 UNIVERSITY MEDICAL CENTER OF SOUTHERN NEVADA (Active)
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Main Details
Name
UNIVERSITY MEDICAL CENTER OF SOUTHERN NEVADA
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH290007
Medicare Provider Number
290007
Additional Details
Current Program Status
Active
Registration Date
4/28/2008
Participating Start Date
7/1/1994
Participating Approval Date
4/28/2008
Last Recertification Date
8/26/2024
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
1800 W Charleston Blvd.
LAS VEGAS, NV 89102
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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6/12/09 UPDATED MEDICAID# (WAS 11-02877)
06/12/2009
May 2025
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